Italian auto racing champion turned Paralympic gold medalist Alex Zanardi underwent a second brain surgery on Monday, 10 days after an emergency operation following a crash on his handbike. The latest surgery lasted 2 ½ hours, after which Zanardi was returned to the intensive care unit in a medically induced coma, the Santa Maria alle Scotte Hospital in Siena said in a medical bulletin.

“His condition remains stable from a cardio-respiratory and metabolic viewpoint, grave from a neurological viewpoint,” the hospital said. Roberto Gusinu, the hospital medical director, said, “The operation that was done represents a step that was foreseen by the medical team."