AGNOSIA
Lack of the ability to recognise objects or other events via the senses. E.g. · Auditory agnosia is an inability to recognise sounds · Tactile agnosia is an inability to recognise objects by touch · Visual agnosia means an inability to recognise objects by sight.
AMNESIA
Loss or impairment of memory. Associated with brain injury are: · Anterograde amnesia: amnesia of events occurring after the trauma or other cause of injury · Retrograde amnesia: amnesia of events occurring before the trauma or other cause of injury · Post-traumatic amnesia (PTA): the period between a head injury and the time the person knows where he is.
ANARTHRIA
see DYSARTHRIA
ANOSMIA
Loss of the sense of smell. In head injury damage often occurs to the Olfactory nerve (cranial nerve I) resulting in anosmia. Its importance includes the danger of being unable to smell gas, smoke etc.
ANOXIA (Hypoxia)
Decreased oxygen supply to organs or tissues. Anoxic damage to the brain may occur as a as a result of head injury or other injuries such as asphyxiation, cardiopulmonary arrest etc.
APHASIA
see DYSPHASIA
APHONIA
see DYSPHONIA
APRAXIA
see DYSPRAXIA
ATAXIA
An impairment of muscular co-ordination; particularly unsteadiness of gait. In relation to ABI it is usually the result of damage to the cerebellum and its pathways. muscles.
BRAINSTEM
The part of the Central Nervous System connecting the brain (cerebrum) to the spinal cord.
BURR HOLE
A hole drilled in the skull bone by a neurosurgeon.
CENTRAL NERVOUS SYSTEM (CNS)
This term refers to the Brain, Brainstem and Spinal cord
CEREBELLUM
The part of the brain that lies at the back of the cerebrum. Its main functions relate to co-ordination and balance.
CEREBRUM
The principal part of the brain. The cerebrum consists of two halves (CEREBRAL HEMISPHERES) referred to as right and left.
CLOSED HEAD INJURY
This refers to an injury to the brain when the skull remains intact in contrast to Penetrating Head Injury (qv) when there is penetration of the skull. The majority of head injuries are closed and the most common mechanism of brain damage is acceleration/deceleration forces acting on the brain.
COGNITION
The act of thinking. Cognitive functions include thinking, concentrating, understanding and memory.
COMA
A state of profound unconsciousness with little or no responsiveness to external stimuli. The most frequently used measure of depth of coma is the Glasgow Coma Scale (see Appendix)
CONCUSSION
A brief reduction of conscious level as a result of closed head injury. It is generally used as a synonym for mild traumatic head injury (see Appendix
CRANIOPLASTY
The operative repair of a defect of the skull
CRANIOTOMY
A surgical operation to open the skull.
CT SCAN
The CT scan (computerised axial tomography), often simply referred to as a brain scan, is a key investigation after brain injury. Essentially it is a form of X-ray where multiple ?slices? are taken and processed by computer to provide detailed pictures of the brain. It is particularly useful in head injury for detecting potentially life threatening complications such as a haematoma requiring surgical treatment or brain swelling. It should be noted, however, that it may not detect diffuse microscopic damage and a ‘normal’ CT scan does not exclude significant brain injury.
DIFFUSE AXONAL INJURY
Widespread and patchy shearing of the axons (nerve fibres) which connect nerve cells in different areas of the brain.
DIPLOPIA
Double vision.
DISINHIBITION
Behaviour which is socially inappropriate (e.g. temper outbursts; swearing; inappropriate sexual advances) May be verbal or physical in nature.
DYSARTHRIA (Anarthria)
An impairment of the ability to pronounce/articulate words.
DYSKINESIA
Involuntary movement. There are several forms of dyskinesia (e.g. chorea, athetosis, akathisia). These may be the result of brain damage or the side-effect of some medications
DYSPHAGIA
Difficulty swallowing
DYSPHASIA (Aphasia)
An impairment of the ability to use and/or understand language.
DYSPRAXIA (Apraxia)
Impairment of the ability to carry out voluntary movements, despite the preservation of muscle power, co-ordination and sensory function. The affected person may be unable to copy a shape or dress.
ELECTROENCEPHALOGRAM (EEG)
A recording of the electrical activity of the brain. Principally used for the investigation of epilepsy.
EPILEPSY
A condition characterised by recurrent seizures. Seizures are the result of abnormal electrical discharges of nerve cells and vary from brief lapses of awareness to loss of consciousness sometimes accompanied by involuntary jerking movements.
EXECUTIVE FUNCTIONS
The abilities that enable a person to engage successfully in independent, purposive, self-serving behaviour. They include initiation, planning and selfregulation of voluntary actions.
FOCAL BRAIN INJURY/DAMAGE
The term focal is used to indicate injury or damage that is localised to a part of the brain in contrast to widespread or diffuse injury.
HAEMATOMA
A localised collection of blood within an organ, tissue or space. In relation to brain injury the following terms are often used. · INTRACRANIAL HAEMATOMA: a collection of blood within the skull · INTRACEREBRAL HAEMATOMA: a collection of blood within the brain itself · EXTRADURAL HAEMATOMA: a collection of blood between the dura and the skull. [ A form of intracranial haematoma) · SUBDURAL HAEMATOMA: a collection of blood between the dura and arachnoid maters. [ A form of intracranial haematoma)
HEMIANOPIA
Loss of visual field on one side.
HEMIPARESIS/HEMIPLEGIA
Weakness/paralysis of the arm and leg on one side of the body. Hemiparesis indicates a less severe loss of movement, while Hemiplegia is used for complete or severe paralysis.
HYDROCEPHALUS
A condition marked by excessive accumulation of cerebrospinal fluid (CSF) within the brain.
HYPOXIA
see ANOXIA
INFARCT
Death of tissue resulting from arrest of circulation in the artery supplying the part. Cerebral infarct refers to a part of the brain damaged by lack of its blood supply and is a common form of stroke.
INTERDISCIPLINARY (Interprofessional) TEAM (IDT)
A team of several different health and related professionals as in a Multidisciplinary Team (qv) but where there is adaptation of the roles, knowledge and skills of individual team members to adjust to those of other team members. This is often referred to as ?role blurring?.
INTRACRANIAL
This adjective means: within the skull. Examples of this terms use are Intracranial haematoma (see Haematoma) and Intracranial Pressure Monitoring which refers to measurement of pressure within the skull.
ISCHAEMIA
Diminished supply of blood. The brain’s supply of blood may be diminished as a direct result of damage to brain structures or due to other injuries (e.g. bleeding from into the abdomen or from an injury to a limb)
LOCKED-IN SYNDROME
A rare condition resulting from localised damage to part of the brainstem, leading to loss of voluntary movement including speech without loss of wakefulness or awareness.
MAGNETIC RESONANCE IMAGING (MRI) SCAN
Unlike a CT scan (qv) this form of brain scan does not involve X-rays but magnets to provide detailed images of the brain. It is more sensitive than CT scan in detecting diffuse axonal injury.’
MINIMALLY CONSCIOUS STATE (MCS)
This refers to a condition when an individual shows minimal but definite evidence of a degree of awareness despite profound cognitive impairment. Patients emerging from the vegetative state (qv) often enter a MCS. [Alternative terms are Minimally responsive or low awareness state]
MONOPARESIS/MONOPLEGIA
Weakness/paralysis of one limb. Monoparesis indicates a less severe loss of movement, while Monoplegia is used for complete or severe paralysis.
MOTOR DISORDERS
This term refers to disorders of movement. These include · weakness and paralysis; · inco-ordination or ataxia (q.v.); · hypokinesis (q.v.) · involuntary movements or dyskinesias (q.v.)
MULTIDISCIPLINARY (Multiprofessional) TEAM (MDT)
Several different health and related professionals working together and communicating with each other with the common purpose of assisting the person with ABI and their family to maximise recovery. However it does not imply that they adapt their skill or knowledge base or change their professional role to fit in with the roles and responsibilities of other team members in contrast to an Interdisciplinary team (qv)
OEDEMA
An accumulation of fluid in tissues (or swelling of tissues). Cerebral oedema refers to swelling of the brain which often requires emergency care to prevent compressing brain tissue which can cause death or further serious brain damage.
PARAPARESIS/PARAPLEGIA
Weakness/paralysis of both legs. Paraparesis indicates a less severe loss of movement, while Paraplegia is used for complete or severe paralysis.
PENETRATING HEAD INJURY
Refers to an injury to the brain when the skull has been breached by a bullet, knife or other object. Such injuries are most common in wartime.
PERIPHERAL NERVOUS SYSTEM
This term refers to the cranial and peripheral nerves.
PROGNOSIS
The prediction of the outcome of an injury or disease.
QUADRIPARESIS/QUADRIPLEGIA (Tetraparesis/tetraplegia)
Weakness/paralysis of both arms and legs. Quadriparesis indicates a less severe loss of movement, while Quadriplegia is used for complete or severe paralysis.
REHABILITATION
The process of assisting the restoration of an individual to their fullest physical, psychological, and social capability after an episode of illness or trauma.
SECONDARY BRAIN DAMAGE
A range of complications which may follow the primary impact damage. Common complications include brain swelling, bleeding inside the head or brain, infection of the brain or its covering.
SPASTICITY
A state of increased muscle tone- a stiffness in muscles when examined by the doctor stretching the muscles.
VEGETATIVE STATE
An individual in a vegetative state shows a degree of wakefulness in that they have cycles of eye opening and closure resembling those of sleep and waking. As a rule the person can breathe spontaneously and has a stable circulation. However there is no evidence of awareness of their environment. · PERSISTENT VEGETATIVE STATE refers to a vegetative state that has continued for four weeks or more · PERMANENT VEGETATIVE STATE (PVS) is used to describe a vegetative state from which the individual is not expected to recover and should only be used after 12 months in the case of trauma and at least 6 months in other causes of acquired brain injury See Glasgow Outcome Scale in Appendix 1