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Medical Glossary

Glossary Terms About Traumatic Brain Injury

This is only a partial list of the hundreds of terms and specialties associated with brain injuries.

| A | B | C| D | E | F | G| H | I | J | K| L | M | N | O| P | Q | R | S| T | U | V | W|

A

Acquired brain injury (ABI):
Is an injury to the brain which is not hereditary, congenital or degenerative, or induced by birth trauma. An acquired brain injury commonly results in a change in neuronal activity, which effects the physical
integrity, the metabolic activity, or the functional ability of the cell. Results may vary from mild, moderate, or severe impairments in one or more areas, including cognition, speech-language communication; memory; attention and concentration; reasoning; abstract thinking; physical functions; psychosocial behavior; and information processing.

Acute Care:
A skilled service delivery, hospital-based, that optimizes medical condition. May or may not receive therapies.

Acute rehabilitation:
Early phase of rehabilitation beginning as soon as patient is medically stable. Includes an interdisclinary term of professionals.

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.

Adaptive/assistive equipment:
A special device, which assists in the performance of self-care, work, play or leisure activities.

Aggressiveness:
A state of irritability; combativeness.

Agnosia:
Failure to recognize familiar objects although the sensory mechanism is intact. May occur for any sensory modality.

Aneurysm:
Localized abnormal dilation of a blood vessel, usually an artery. Due to congenital defect or weakness of the wall of the vessel. If dilation increases, the wall weaken and may eventually burst, causing a hemorrhage.

Anger:
Is a very basic human emotion. It plays an important role in the way we communicate with others. It communicates strong feelings of displeasure and rage. Generally speaking, the word “anger” expresses the emotion but does not necessarily convey intensity, justification, and “form” of the anger.

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.

Anoxia:
Lack of oxygen to the brain.

Anticonvulsant:
Medication to decrease possibility of seizures.

Anti-Social Behavior:
Behavior that is contrary to the customs, standards and moral principles accepted by society.

Anxiety:
Feelings of apprehension, uneasiness, agitation, uncertainty and fear because of threat or danger.

Aphasia:
The inability to produce voluntary speech due to a deficit in motor (muscle) programming caused by brain damage.

Apraxia:
Loss of the ability to execute or carry out learned purposeful movements, despite having the desire to perform the movements.

Asphyxia:
Condition caused by insufficient intake of oxygen.

Assessment:
An evaluation of a patient based on the following information: 1. The subjective report of the symptoms by the patient. 2. The progress of the illness or condition. 3. The objective findings of the examiner based on tests, physical examination
and medical history.

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.

Attention:
Ability to focus on a given task for an appropriate period of time.

Audiologist:
One who evaluates hearing defects and who aids in the rehabilitation of those who have such defects.

Audiology:
The study of hearing disorders through identification and evaluation of hearing loss, and the rehabilitation of persons with hearing loss, esp. that which cannot be improved by medical or surgical means.

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B

Balance:
The ability to use appropriate righting and equilibrium reactions to maintain an upright position. It is usually tested in sitting and standing positions.

Bilateral:
Pertaining to both sides of the boby.

Brain:
The brain has many parts including the cerebral cortex, brain stem and cerebellum. The brain is a very complex organ; it regulates every aspect of human behavior. Everything about ourselves and the environment is experienced through the brain. It has been described as a three-pound universe. It is thought to house the seat of the self, the place where the sense of self resides. Damage to the hippocampus interferes with the ability to store new memories. Likewise, the ability to use
language recognize familiar faces, to count, read and many other higher functions are dependent on intact memory functions. Impairments in such basic functions are fundamental to personal identity. Wipe out one part of the brain and the person speaks fluent gibberish; other damage interferes with the ability to recognize familiar faces.

Brain Injury:
Damage to the brain that results in impairments in one or more functions.

Brain Stem:
The Stemlike part of the brain that connects the cerebral hemispheres with the spinal cord. Neurological functions of the brain stem are necessary for survival (breathing, heart rate) and for arousal (being awake and alert).

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C

Cerebellum:
Located in the back of the brain, the cerebellum is involved in synergic control of muscles and plays an important role in the coordination of volunary muscular movements. Damage may result in ataxia.

Cerebral-spinal fluid (CSF):
A colorless solution similar to plasma protecting the brain and spinal cord from physical impact. Usually shrinking or expanding of the cranial contents is quickly balanced by increase or decrease of this fluid. CSF circulates
through the subarachnoid space. For diagnosis purposes, a lumbar puncture (spinal tap) is used to draw CSF.

Closed head injury:
Trauma to the head without penetration of the skull regardless of severity. Also see Traumatic Brain Injury, Minor Head Injury and Concussion.

Cognitive impairment:
Difficulty with basic brain functions- perception, memory, attention or reasoning.

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 that 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:
State of unconsciousness from which the patient cannot be awakened or aroused, even by powerful stimulation; lack of any response to one’s environment. Defined clinically as an inablility to follow a one-step command consistently. Glasgow Coma Scale of 8 or less.

Comprehension:
Ability to understand spoken, written, or general communication.

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.”

Confusion:
A state in which a person is bewildered, perplexed, or unable to self-orient.

Contrecoup:
Bruising of brain tissue on side opposite where the blow was struck.

CT Scan:
Computerized Tomography (like an X-Ray) is a test which takes a close look at the functioning of the brain by projecting an accurate picture. This test helps locate physical damage to the brain.

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D

Delusions:
Thought disturbances; hallucinations.

Denial:
Defense mechanism allowing an individual to maintain that a problem has been resolved with an increase in personal competence, although the problem still remains. It protects against physical or emotional conflict or loss. Many rehab professionals over ascribe denial to their patients. Hoping for functional improvement should not be misunderstood as denying disability.

Depression:
An abnormal emotional state in which the individual experiences an exaggerated feeling of sadness, worthlessness and hopelessness, inappropriate and out of proportion to some personal loss or tragedy.

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.

Disability:
The loss, absence or impairment of physical or mental fitness that can be seen or measured.

Disinhibition:
Inability to control impulsive behavior and emotions.

Disorientation:
Not knowing where you are, who you are, or current date.

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.

Dysphasia:
Impairment of speech resulting from a brain lesion.

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E

Edema:
Collection of fluid in the tissue causing swelling.

EEG (Electroencepalogram):
The electroencephalogram measures “electrical” currents from nerve cells of the brain. This test helps diagnose specific neurological conditions, especially the presence of a seizure disorder.

EKG (Electrocardiogram):
The electrocardiogram measures variations in the heart and heart muscle by connecting electrodes to the chest. Patients in the emergency room and intensive care units often are monitored with a EKG to assure normal heart functioning.

Endotracheal tube:
A tube that serves as an artificial airway that is inserted through the patient’s moth or nose.

Executive functions:
The capacities necessary to formulate, plan and carry out effectively. These functions are essential for independent, creative and socially constructive behavior. These are controlled by the frontal lobe.

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F

Fatigue:
A state of exhaustion; the loss of strength or endurance.

  • Acute: Fatigue with sudden onset such as occurs following excessive exertion; relieved by rest.
  • Chronic: Long-continued fatigue not relieved by rest. Indicative of disease such as tuberculosis or diabetes or other conditions of altered body metabolism.
  • Muscular: The reduced capacity of a muscle to perform work as a result of repeated contractions. Fatigue may be partial or complete.

Frontal Lobe:
Front part of the brain; involved in planning, organizing, problem solving, selective attention, personality, and a variety of higher level thinking.

Functional:
The ability to carry out a purposeful activity.

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G

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.

Grief Process:
Emotional responses to grief which progress from alarm to disbelief and denial, to anger and guilt, to finding a source of comfort, and finally to adjustment.

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H

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.

Hematoma:
Collection of blood in tissue or a space following the ruture of blood vessel.

Types include:

  • Epidural Hematoma-  Outside the brain and its fibrous covering but under the skull.
  • Subdural Hematoma-  Between the brain and its fibrous covering (dura).
  • Intracerebral Hematoma-  In the brain tissue.
  • Subarachnoid Hematoma-  Around surface of the brain, between the dura and arachnoid membranes.

Hemiparesis: 
Weakness of one side of the body.

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.

Hemorrhage:
Abnormal internal or external discharge of blood. May be venous, arterial or capillary from blood vessels into tissues, into or from the body.

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

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I

ICP
Monitor:
Intracranial Pressure Monitor indicates pressure within the brain. It consists of a small tube attached to the patient at the skull and then to a monitoring device. The ICP monitor helps assure close observation of activity within the brain which may result in swelling of the brain.

Impulse control: Ability to withhold inappropriate verbal or motor responses while completing a task.

Impulsively:
A tendency to act without thinking; the acting out of a sudden, irresistible and irrational urge or desire; the spontaneous physical activity that results when an irritation caused by stimuli passes through tissue, especially muscle and nerve
tissue.

Independent:
Ability to perform a task without assistance or supervision.

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J

Judgment:
The ability to form a correct conclusion based on knowledge and experience.

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K

Kinesthesia:
Sensory awareness of body parts as they move.



L

Lability:
Notable shifts in emotional state (e.g., uncontrolled laughing or crying)

Lethargic:
Awakens with stimulation; drowsy but awake.

Long-term memory:
Ability to easily recall feelings, events, ideas, and other information from a long time ago.

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M

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.

Medicaid:
State and federal program of public assistance to persons of all ages whose income and resources are insufficient to pay for health care.

Medicare:
Hospital and supplimentary medical insurance for disabled or aged persons under the Social Security Act.

Medical Social Worker:
A professional who helps arrange services and programs for the patient and family by communication between other professionals, insurance provider, patient and family. The Medical Social Worker is instrumental in discharge planning.

Memory:
Ability to retain and recall information.

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

Mobility:
Ability of an individual to move within, and interact with the environment.

MRI:
Magnetic Resonance Imaging, high tech diagnostic tool to display tissues unseen in X-rays or other techniques.

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N

Nasogastric tube (NG tube):
Tube that passes 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.

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.

Neuropscychologist:
A specialist involved in evaluation and treatment in the functional behavioral aspects of rehabilitation. The neuropsychologist evaluates actual brain functioning in relation to real life activities, behavior and social adjustment.

Neurosurgeon/Neurologist:
A physician who specializes in the treatment of patients with a variety of brain functioning difficulties. The surgeon may perform brain or spinal cord surgery when indicated.

NPO:
Latin initials for “nothing by mouth”. This means no liquids or foods for a set period, usually in preparation for certain tests, or when a person cannot safely swallow.

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O

Occipital lobe:
Region in the back of the brain which processes visual information.

Occupational Therapist:
A professional who uses purposeful activity in the treatment of physically impaired individuals and helps them achieve maximum optimal functioning. The following areas are evaluated and addressed in the treatment of the brain-injured
person as appropriate: self care skills; cognitive/visual perceptual retraining; sensory stimulation; splint fabrication; upper extremity gross and fine motor activities; practical community skills such as prevocational training, money management and home visits to adapt physical environments to specific needs.

Open head injury:
Trauma to the brain resulting in loss of consciousness due to the penetration of the brain by a foreign object such as a bullet. Also called Major Head Injury, Acute Head Injury, or Severe Head Injury.

Optometrist:
A person specifically trained to examine the eyes in order to test visual acuity and to prescribe and adapt lenses to preserve or restore maximum efficiency of
vision.

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P

Paraparesis:
Weakness of lower limbs.

Parietal lobe:
One of the two parietal lobes of the brain located behind the frontal lobe at the top of the brain.

Perception:
Ability to make sense of what one sees, hears, feels, tastes or smells. Perceptual
losses are often very subtle and the patient and/or family are unaware of them.

Physiatrist:
A physician specializing in physical medicine and rehabilitation is involved in the evalutation of physical functioning of the body following injury and during the patient’s rehabilitation.

Physical Therapist:
A professional who evaluates and treats the brain injured patient for neuromuscular deficits to maximize the patient’s return to functional activities. Interventions include posturing, adaptive equipment, therapeutic exercise, motor planning activities, transfer and gait training.

Post concussion syndrome:
Group of symptoms after a concussion that may include memory changes, mood swings, poor concentration, headache, dizziness, depression, and anxiety.

Problem-solving:
Ability to bring cognitive process to figure out how to do a task.

Prognosis:
Prospect for recovery from a disease or injury based on nature and symptoms of the case.

Psychologist:
Professional specializing in counseling, including adjustment to disability. Uses tests to indentify personality and cognitive functioning.

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Q

Quadriparesis:
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.

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R

Range of motion (ROM):
The normal range of movement of any body joint. Range of motion also refers to exercises designed to maintain this range and prevent contractures.

Reasoning:
The ability to think out logically.

Recreation therapist:
Responsible for developing a program to help persons with disabilities plan and manage leisure activities.

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.

Rehabilitation:
Comprehensive program to help individuals reach optimal mental and physical abilities or adjustment after an illness or disability.

Respite Care:
A means for taking over the care of a person temporarily (for a few hours to a few days) to provide a period of relief for the primary caregiver.

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S

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.

Shunt:
Procedures to draw off excess fluid in brain. Surgically-placed tube running from ventricles deposits fluid into abdominal cavity, heart or large veins of the neck.

Social worker:
Acts as liaison between professionals and others including: family, funding sources, friends, and representatives of past or future placements.

Spasticity:
Involuntary increase in muscle tone that occurs following injury to the brain or spinal cord, causing muscles to resist being moved.

Speech-Language Pathologist:
A Professional who evaluates and treats disorders of comprehension, reading, memory, orientation, oral-motor functioning, writing and cognition which may be present following a closed brain injury.

Spinal Shock:
Similar to a concussion in the brain, spinal shock causes the system to shut down. In spinal cord injury, shock causes immediate flaccid paralysis, which lasts about three or four weeks. Improvement then occurs to a great extent, due to several possibilities: restoration of blood flow; synaptic reconnection; restoration of myelin integrity and axonal connection.

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T

Temporal lobes:
There are two temporal lobes, one on each side of the brain located about level with the ears. These lobes allow a person to tell one smell form another and one sound from another. They also help sort new information.

Tracheostomy:
Temporary surgical opening at the front of the throat providing access to the trachea or windpipe to assist in breathing.

Trauma:
A physical injury caused by violent or disruptive action; a psychological injury caused by severe emotional shock.

Traumatic brain injury:
(TBI) means an acquired injury to the brain caused by an external physicial force, resulting in total or partial functional disability or psychosocial impairment. The term applies to open or closed head injuries resulting in impairments in one or more areas, such as congnition, language, memory, attention, reasoning, abstract thinking, judgement, problem-solving, sensory, perceptual and motor abilities, psychosocial behavior, physical functions, information processing, and speech.

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U

Unilateral:
Pertaining to one side of the body.



V

Vegetative State:
Condition in which the person utters no words and does not follow commands or make any response that is psychologically meaningful.

Ventilator:
Machine which helps an individual breathe, keeps airway passages in the throat clear and provides adequate oxygen to the body.

Ventricles, brain:
Four natural cavities in the brain filled with spinal fluid. Outline of one or more of these cavities may change when a space occupying lesion (hemorrhage, tumor) develops.

Vocational evaluation:
Comprehensive process that systemically uses work, real or simulated, as a focal point for assessment and vocational exploration.

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W

Wheelchair tolerance:
Amount of time a person is able to sit in a wheelchair, determined by the skin’s response to pressure while sitting and ability to sit without excessive fatigue.

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.

Withdrawal:
A response to physical danger or severe stress characterized by a state of apathy, lethargy, depression and retreat into oneself.

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Resources for this glossary

Lehmkuhl, L Don. Brain Injury Glossary. The Traumatic Brain Injury Model System Research
Program of TIRR. HDI Publishers, Houston, Texas 1996.

Head Injury Hotline. TBI Glossary. 1998. www.headinjury.com/tbiglossary.htm

While you are waiting. About Brain Injury: A Glossary of Terms. 1997. www.waiting.com

TBI Project A.C.C.E.S.S. North Carolina Department of Health and Human Services, Division
of Mental Helath, Developmental Disabilities and Subtance Abuse Services.

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