Definitions

Here are the words which are used in relating to Brain Injury.
We suggest you print out this list for your easy reference.

ADAPTIVE / ASSISTIVE EQUIPMENT — a special device which assists in the performance of self care, work, play or leisure activities.

ADL — activities of daily living. Routine activities carried out for personal hygiene and health such as eating, dressing, grooming, shaving, etc. Nurses, occupational and physical therapists are the main coaches for ADL, which is sometimes called DLS or daily living skills.

AGNOSIA — failure to recognize familiar objects although the sensory mechanism is intact. May occur for any sensory modality.

ANEURYSM — a balloon-like deformity in the wall of a blood vessel. The wall weakens as the balloon grows larger, and may eventually burst, causing a hemorrhage.

ANOMIA — inability to recall names of objects. Persons with this problem often can speak fluently but have to use other words to describe familiar objects.

ANOSMIA — loss of the sense of smell. SYN: anodmia

ANOXIA — a lack of oxygen. Cells of the brain need oxygen to stay alive. When blood flow to the brain is reduced or when oxygen in the blood is too low, brain cells are damaged.

APHASIA — the change in language function due to an injury to the cerebral cortex of brain. It causes partial or total loss of ability to express oneself and/or to understand language.

APRAXIA — the inability to produce voluntary speech due to a deficit in motor (muscle) programming caused by brain damage.

ATAXIA — a problem of muscle coordination not due to apraxia, weakness, rigidity, spasticity or sensory loss. Caused by lesion of the cerebellum or basal ganglia. Can interfere with a person's ability to walk, talk, eat and to perform other self-care tasks.

AUDIOLOGIST — one who evaluates hearing defects and who aids in the rehabilitation of those who have such defects

BRAIN INJURY (ACQUIRED) ABI — is an injury to the brain that is not hereditary, congenital or degenerative. Causes of ABI include external forces applied to the head and/or neck (traumatic brain injury), anoxic/hypoxic injury (e.g. cardiopulmonary arrest, carbon monoxide poisoning, airway obstruction, hemorrhage age), intracranial surgery, vascular disruption, infectious diseases, intracranial neoplasm, metabolic disorder, seizure disorder and toxic exposure (e.g., substance abuse, ingestion of lead and inhalation of volatile agents).

BRAIN INJURY (TRAUMATIC) — is an insult to the brain, not of a degenerative or congenital nature, caused by an external physical force that may produce a diminished or altered state of consciousness, which results in an impairment of cognitive abilities or physical functioning. It can also result in the disturbance of behavioral or emotional functioning.

BRAINSTEM — the lower extension of the brain where it connects to the spinal cord. Neurological functions located in the brainstem include those necessary for survival (breathing, heart rate) and for arousal (being awake and alert).

CENTRAL NERVOUS SYSTEM (CNS) — the CNS includes the brain and spinal cord. The prevailing theory is that CNS cells won't repair themselves. Experiments show, however, that CNS nerves can re-grow and reconnect to appropriate targets. A clinical "fix" for spinal cord injury has not yet been found.

CEREBELLUM — the portion of the brain (located in the back) that helps coordinate movement. Damage may result in Ataxia.

CEREBROSPINAL FLUID (CSF) — a colorless solution similar to plasma protecting the brain and spinal cord from shock. CSF circulates through the subarachnoid space. For diagnosis purposes, a lumbar puncture (spinal tap) is used to draw CSF.

CERVICAL — the upper spine (neck) area of the vertebral column. Cervical injuries often result in quadriplegia (tetraplegia).

COGNITION — the mental process involved in knowing, thinking, learning, and judging.

COGNITIVE DISSONANCE — individual awareness of inconsistencies in thoughts, feelings, rationale and opinions.

COGNITIVE FUNCTION — an intellectual process by which a person becomes aware of, perceives or understands ideas.

COGNITIVE PROCESS — higher mental functioning; learning, memory, imagination, comprehension, decision making. The means by which an individual becomes aware of people, objects and situations in the environment and their subjective, symbolic meaning.

COGNITIVE REHABILITATION — therapy programs which aid persons in the management of specific problems in thinking and perception. Skills are practiced and strategies are taught to help improve function and/or compensate for remaining deficits.

COMA — a state of profound unconsciousness. A state of unconsciousness from which the person is incapable of any conscious action. Typically, they do not respond to powerful stimulation; lack of any response to one's environment.

CONCUSSION — a violent blow, jarring, shaking or other non penetrating injury to the brain. Frequently, but not always, accompanied by a loss of consciousness. Also called Minor Head Injury and Traumatic Brain Injury. Slang terms include: having one's "bell rung," and "ding."

CT SCAN — computerized axial tomography is a cross-sectional X-ray enhancement technique that greatly benefits diagnosis with high-resolution video images, some in three dimensions.

DIFFUSE AXONAL INJURY (DAI) — a shearing injury of large nerve fibers (axons covered with myelin) in many areas of the brain. It appears to be one of the two primary lesions of brain injury, the other being stretching or shearing of blood vessels from the same forces, producing hemorrhage.

DIFFUSE BRAIN INJURY — injury to cells in many areas of the brain rather than in one specific location.

DIPLOPIA — seeing two images of a single object; double vision.

DISABILITY — the loss, absence or impairment of physical or mental fitness that can be seen or measured.

DISCHARGE PLANNING — preparation for life after rehab, including insurance and legal issues, home adaptation, and community support issues.

DISCRIMINATION, SENSORY — a process requiring differentiation of two or more stimuli.

DISINHIBITION — impaired ability to restrain from acting on an impulse or desire.

DISORIENTATION — mental confusion with regard to time, place, personal identity and relationships.

DISTRACTIBILITY — inability to maintain attention; over-reaction to stimuli.

DORSAL ROOT — the collection of nerves entering the dorsal section (on the back) of a spinal cord segment. These roots share central and peripheral nerve connections, and enter the spinal cord in an area called the dorsal root entry zone (DREZ).

DURA MATER — the outermost of three membranes protecting the brain and spinal cord, it is tough and leather like

DYSARTHRIA — difficulty in forming words or speaking them because of weakness of muscles used in speaking. Speech is characterized by slurred, imprecise articulation. Tongue movements are usually labored and the rate of speaking may be very slow. Voice quality may be abnormal, usually excessively nasal; volume may be weak; drooling may occur. Dysarthria may accompany aphasia or occur alone.

DYSPHAGIA — difficulty in swallowing. It also includes difficulty in moving material from the mouth to the stomach. This definition also includes problems in positioning food in the mouth.

ELECTROMYOGRAM (EMG) — a test that records the responses of muscles to electrical stimulation.

ENCEPHALOGRAPHY — non-invasive use of ultrasound waves to record echoes from brain tissue. Used to detect hematoma, tumor or ventricle problems.

FES (Functional Electric Stimulation) — the application of low-level, computer controlled electric current to the neuromuscular system, including paralyzed muscle. FES is used to enhance or produce functions such as walking or bike exercises. FES has been used in experiments to facilitate grip in individuals with tetraplegia, using a switch activated by shoulder shrug. Other uses include correction of scoliosis, bladder control, electro-ejaculation, phrenic nerve stimulation.

FLACCIDITY — a form of paralysis in which muscles are soft and limp.

GANGLION — a mass of nervous tissue composed principally of nerve-cell bodies and lying outside the brain or spinal cord

GI TUBE — a tube inserted through a surgical opening into the stomach. It is used to introduce liquids, food or medication into the stomach when the person is unable to take these substances by mouth.

GLASGOW COMA SCALE — a standardized system used to assess the degree of brain impairment and to identify the seriousness of injury in relation to outcome. The system involves three determinants: eye opening, verbal responses and motor response. These three determinants are evaluated independently according to a numerical value. The resultant value indicates the level of consciousness and degree of dysfunction. Scores run from a high of 15 to a low of 3. Persons are considered to have experienced a 'mild brain' injury when their score is 13 to 15. A score of 9 to 12 is considered to reflect a 'moderate' brain injury and a score of 8 or less reflects a 'severe' brain injury.

GLOSS PHARYNGEAL BREATHING (GPB) — a means of forcing extra air into the lungs to expand the chest and achieve a functional cough. Also called "frog breathing."

HALO TRACTION — The process of immobilizing the upper body and cervical spine with a traction device. The device consists of a metal ring around the head, held in place with pins into the skull. A supporting frame is attached to the ring and to a body jacket or vest to provide immobilization.

HEAD INJURY — any traumatic injury to the head regardless of severity. Types of head injury include penetration of the skull by a foreign object such as a bullet. Others result from a blow to the head as in an impact injury. Others are caused by a violent shaking or whiplash of the head.

HEMA — combining form indicating blood.

HEMATOMA — the collection of blood in tissues or a space following rupture of a blood vessel. 
Epidural — Outside the brain and its fibrous covering, but under the skull.
Subdural — Between the brain and its fibrous covering. 
Intracerebral — In the brain tissue

HEMIANOPSIA — visual field cut. Blindness for one half of the field of vision. This is not the right or left eye, but the right or left half of vision in each eye.

HEMIPLEGIA — paralysis of one side of the body as a result of injury to neurons carrying signals to muscles from the motor areas of the brain.

HEMIPARESIS — weakness, paralysis or loss of movement on one side of the body.

HEMIANOPSIA — loss of part of one's visual field in one or both eyes.

HEMORRHAGE — abnormal internal or external discharge of blood. May be venous, arterial or capillary from blood vessels into tissues, into or from the body. Venous blood is dark red; flow is continuous. Arterial blood is bright red; flows in jets. Capillary blood is of a reddish color; exudes from tissue.

HYPOTHERMIA — a technique used to cool the spinal cord after injury. Hypothermia may reduce metabolic and oxygen requirements of the injured tissue and may reduce edema (swelling), which in turn may reduce secondary nerve fiber damage. Because of technical problems (it may involve exposing the spinal cord), hypothermia is not widely in use at spinal centers in the U.S.

HYPOXIA — lack of blood oxygen due to impaired lung function. Important in emergency treatment for quads. Hypoxia can further damage oxygen sensitive nerve tissue.

INTRACRANIAL PRESSURE (ICP) — cerebro-spinal fluid (CSF) pressure measured from a needle or bolt introduced into the CSF space surrounding the brain. It reflects the pressure inside of the skull.

INTRACRANIAL PRESSURE MONITOR — an ICP monitor. A monitoring device to determine the pressure within the brain. It consists of a small tube (catheter) attached to the person at the skull by either a ventriculostomy, subarachnoid bolt, or screw, and is then connected to a transducer, which registers the pressure.

INTRAVENOUS PYELOGRAM (IVP) — an x-ray of the kidney to determine function.

ISCHEMIA — a reduction of blood flow that is thought to be a major cause of secondary injury to the brain or spinal cord after trauma.

LAMINECTOMY — an operation used to relieve pressure on the spinal cord, or used to examine the extent of damage to the cord.

LATERAL ANTERIOR DECOMPRESSION — surgical procedure to reduce pressure on the spinal cord by removing bone fragments. Some patients report dramatic functional improvement. It must be noted that medical success depends on patient selection since not all people qualify and not all benefit from this kind of surgery. Some conditions may worsen after surgery.

LOCKED-IN SYNDROME — A condition resulting from interruption of motor pathways in the ventral pons, usually by infarction. This disconnection of the motor cells in the spinal cord from controlling signals issued by the brain leaves the person completely paralyzed and mute, but able to receive and understand sensory stimuli; communication may be possible by code using blinking, or movements of the jaw or eyes, all of which are spared.

MAJOR HEAD INJURY — trauma to the brain resulting in loss of consciousness. Such head injuries frequently result from due to penetration of the brain by a foreign object such as a bullet wound or a crushing blow. However, the brain may sustain a major injury without a penetrating injury of the skull.

MENTAL STATUS EXAMINATIONS — standardized tests which evaluate verbal responses and behavioral reactions; a procedure used to determine the mental competency of an individual.

MINOR HEAD INJURY — trauma to the head regardless of severity that does not necessarily result in the loss of consciousness. Frequently called Concussion, Traumatic Brain Injury, and Closed Head Injury.

MRI (Magnetic Resonance Imaging) — A high tech diagnostic tool to display tissues unseen in X-rays or by other techniques.

MYELIN — A white, fatty insulating material for axons which produced in the peripheral nervous system by Schwann cells, and in the central nervous system by oligodendrocytes. Myelin is necessary for rapid signal transmission along nerve fibers, ten to one hundred times faster than in bare fibers lacking its insulation properties. Loss of myelin accompanies many central nervous system injuries and is the principal cause of multiple sclerosis. The process of remyelination is very important in spinal cord injury research. If this is possible in the body, as many researchers believe, it may be possible to return function to intact nerve fibers. Oligodendrocytes are apparently unable to provide myelin in the mature central nervous system.

MYELOGRAM — A diagnostic test in which an opaque liquid is injected into the spinal canal, producing an outline of it on X-rays or fluoroscope. Now somewhat outdated by modern imaging diagnostics. Some dyes are suspected of causing additional neurological problems.

NASOGASTRIC TUBE (NG Tube) — tube that pass through the person's nose and throat and ends in the person's stomach. This tube allows for direct "tube feeding" to maintain the nutritional status of the person or removal of stomach acids.

NEUROLOGICAL EXAMINATION — an examination of he nervous system which includes an evaluation of mental Competency.

NEUROLOGIST — a physician who specializes in the nervous system and its disorders.

NEUROPSYCHOLOGICAL ASSESSMENT — an evaluation of the patient's brain functions relating to behavior; based on the results of standardized tests, history, present circumstances, attitudes and the expectations of the patient was well as the patient's behavior during the examination.

NEUROPSYCHOLOGICAL EXAMINATION — the process of administering standardized tests designed to demonstrate brain dysfunction and its effects on behavior.

NEUROTRANSMITTER — A chemical released from a neuron ending, at a synapse, to either excite or inhibit the adjacent neuron or muscle cell. Stored in vesicles near the synapse, the chemical is released when an impulse arrives.

OCCUPATIONAL THERAPIST (OT) — the member of the rehabilitation team who helps maximize a person's independence. OTs teach daily living activities, health maintenance and self care, and consult on equipment choices.

PARAPLEGIA — loss of function below the cervical spinal cord segments, wherein the upper body retains most function and sensation. Paraplegia results in paralysis of the lower limbs; however, the degree of loss depends on the level of spinal cord lesion.

PARIETAL LOBE — one of the two parietal lobes of the brain located behind the frontal lobe at the top of the brain.

PARIETAL LOBE, RIGHT — damage of this area can cause visual-spatial deficits (e.g., the person may have difficulty finding their way around new or familiar places).

PARIETAL LOBE, LEFT — damage to this area may disrupt a person's ability to understand spoken and/or written language

PERIPHERAL NERVOUS SYSTEM — nerves outside the spinal cord and brain (not part of the central nervous system). If damaged, peripheral nerves have the ability to regenerate.

PERPLEXITY — a state of being bewildered and concerned; a distrust of one's own ability and a search for reassurance.

PERSEVERATION — repetition of the same verbal response or motor activity regardless of the stimuli or its duration; persistence at a task that prevents the individual from turning his attention to new situations. A symptom of traumatic brain injury indicating difficulty in regulating behavior in response to rapidly changing demands

PHYSIATRIST — a doctor whose specialty is physical medicine and rehabilitation.

PHYSICAL THERAPIST (PT) — a member of the rehabilitation team. The PT examines, tests, and treats persons to enhance their maximum physical activity.

PLASTICITY — long-term adaptive mechanism by which the nervous system restores or modifies itself toward normal levels of function. The peripheral nervous system is quite plastic, while the central nervous system was long thought to be "wired" permanently, lacking plasticity. It is known now that the central nervous system reorganizes or forms new synapses in response to injury. In lower species (including some kinds of songbirds), it has been shown that the central nervous system can actually create new nerve cells in animal adults.

POST CONCUSSION SYNDROME — a particular group of impairments that characterize the effects of injury on the brain and behavior. PCS include impairments in the ability to think, to do, and to know. PCS is characterized by diminished, self-awareness and diminished ability to benefit from experience. Other difficulties include unreliable memory, rapid mood swings, poor concentration, headache, dizziness, hypersensitivity, depression and anxiety.

POST TRAUMATIC AMNESIA — memory loss caused by brain damage or severe emotional injury.

POST TRAUMATIC STRESS DISORDER — Not long ago, post traumatic stress disorder, PTSD, used to be known as "shell shock" or "battle fatigue." The old terms were popularized during World War II, and continued to be so until just recently. Back then, PTSD was thought to affect only combat veterans. Now, scientist know that, in fact, survivors of atrocities such as the Holocaust, torture, rape, domestic violence, child abuse, war, natural disasters, catastrophic illnesses, and horrific accidents, are susceptible to post traumatic stress disorder, PTSD.

PSYCHIC TRAUMA — an emotional shock or distressful situation that produces a lasting impression on the inner essence of an individual.

PSYCHOGENIC — originating in the mind; a physical symptom, disease or emotional state that is of mental rather than physical origin.

PSYCHOLOGICAL EXAMINATION — a group of standardized tests designed to measure an individual's intellectual capacity, motivation, perception, role behavior, values, level of anxiety, coping mechanisms, depression and general personality integration.

PSYCHOMETRIC INSTRUMENT — standardized tests (utilizing paper and pencil) which measure mental functioning.

QUADRAPARESIS — partial loss of function all four (4) extremities of the body.

QUADRIPLEGIA — loss of function of any injured or diseased cervical spinal cord segment, affecting all four body limbs. Outside the U.S. the term tetraplegia is used (which is etymologically more accurate, combining tetra + plegia, both from the Greek, rather than quadri + plegia, a Latin/Greek amalgam).

REGENERATION — in brain or spinal cord injury, regeneration is the regrowth of nerve fiber tissue by way of some as yet unknown biologic process. In the peripheral system, nerves do regenerate after damage, and reform functional connections. Regeneration researchers are confident central nerves can be induced to grow, provided the proper environment is created. The challenge remains to restore functional connections to effectively restore function.

RANCHO LOS AMIGOS LEVELS — a scale of Cognitive Levels and Expected Behavior

Level I — (No Response) Unresponsive to stimuli.

Level II — (Generalized) Inconsistent, nonpurposeful nonspecific reactions to stimuli.

Level III — (Localized Response) Inconsistent reaction directly related to type of stimulus presented.

Level IV — (Confused, Agitated) Disoriented and unaware of present events
of frequent bizarre and inappropriate behavior, attention span is short and
ability to process information is impaired.

Level V — (Confused, Inappropriate Nonagitated)Nonpurposeful, random of fragmented responses when task complexity exceeds abilities, patient appears alert and responds to simple commands; performs previously learned tasks but is unable to learn new ones.

Level VI — (Confused, Appropriate) Behavior is goal-directed; responses are appropriate to the situation with incorrect responses because of memory difficulties.

Level VII — (Automatic, Appropriate) Correct routine responses that are robot-like; appears oriented to setting, but insight, judgement, and problem solving are poor.

Level VIII — (Purposeful, Appropriate) Correct responses, carryover of new learning, no required supervision, poor tolerance for stress, and some abstract reasoning difficulties.

REHABILITATION — a sequence of services built around the problems of a disabled individual and designed to restore optimum physical, psychological, social and vocational levels of function.

SEIZURE — an uncontrolled discharge of nerve cells which may spread to other cells nearby or throughout the entire brain. It usually lasts only a few minutes. It may be associated with loss of consciousness, loss of bowel and bladder control and tremors. May also cause aggression, and other behavioral changes.

SENSORY STIMULATION — arousing the brain through any of the senses.

SHUNT — a tube used to drain a cavity. In the spinal cord, a shunt is used to treat a syrinx by equalizing pressures between the syrinx and the spinal fluids. In spinal bifida, it is used to reduce pressure of hydrocephalus.

SYNAPSE — the specialized junction between a neuron and another neuron or muscle cell for transfer of information such as brain signals, sensory inputs, etc., along the nervous system. One neuron may have many synapses with other neurons. As an impulse traveling along a nerve fiber arrives at the pre-synaptic area, it releases a neurotransmitter. The transmitter travels across the synapse and binds with a receptor on the post-synaptic membrane of the other cell.

TRAUMA — a physical injury caused by violent or disruptive action; a psychological injury caused by severe emotional shock.

VEGETATIVE STATE — a condition in which the person utters no words and does not follow commands or make any response that is psychologically meaningful.

VENTILATOR — mechanical device to facilitate breathing in persons with impaired diaphragm function. Also known as respirator.

WHIPLASH INJURY — an injury to the neck that causes violent back and forth movement of the head and neck such as in a rear end car collision. Such injuries have been known to cause brain damage even though there was no direct injury to the head.