Glossary of Terms
A
- Acute Rehabilitation Program:
- The primary emphasis is on the early phase of rehabilitation, which usually begins, as soon as the patient is medically stable. It is a comprehensive program based in a medical facility, provided by a dedicated rehabilitation team.
- Amnesia:
- A partial or total loss of the ability to remember things which have been done or experienced before. (See post-traumatic amnesia and retrograde amnesia).
- Aneurism:
- A balloon-like deformity in the wall of a blood vessel, which may eventually burst, causing a haemorrhage.
- Anoxia:
- Lack of oxygen supply to the brain cells.
- Anticonvulsant:
- Medication used to decrease the possibility of a seizure (e.g. Dilantin, Phenobarbital, Mysoline, and Tegretol).
- Aphasia:
- Reduction of the ability to communicate with others through the use of language. Receptive aphasia does not understand the language of others. Expressive aphasia is a reduction in the ability to use language, for example naming and making mistakes in word usage.
- Apraxia:
- Inability to perform or carry out a complex, skilled movement, whilst still having the ability to move and beware of the movement.
- Aspiration:
- When fluid or food enters the lungs through the windpipe. Can cause a lung infection or pneumonia.
- Ataxia:
- Some difficulties with co-ordination, which can interfere with a personís ability to talk, walk, eat and perform other self-care tasks.
- Attention/Concentration:
- The ability to focus on a given task for a given period of time.
B
- Balance:
- The ability to maintain an upright position, which is usually tested in sitting and standing positions.
- Behaviour:
- Actions and reactions presented by a person.
- Bilateral:
- Both right and left sides.
- Brain Injury, Acquired:
- This term is that the individual experienced a normal growth and development from conception through birth, until sustaining an insult to the brain some time later, causing impairment in brain function. Can be caused by insufficient blood supply to the brain, toxic substances, malignancy, congenital disorders, birth trauma or degenerative disorders.
- Brain Injury, Closed:
- Occurs when the head accelerates and then rapidly decelerates or collides with another object (for example the windshield of a car) and brain tissue is damaged, not by the presence of a foreign object within the brain, but by a violent smashing, stretching, and twisting, of brain tissue. Closed brain injuries typically cause diffuse tissue damage that results in disabilities, which are generalised and highly variable.
- Brain Injury, Mild:
- An individual with a mild traumatic brain injury who has had a psychological disruption of brain function, which can be manifested by at least one of the following:
- A period of loss of consciousness.
- Any loss of memory for events immediately before or after the accident.
- Any alteration in mental state at the time of the accident (e.g. feeling dazed, disorientated or confused).
- Focal neurological deficit (s) which may or may not be transient; but where the severity of the injury does not exceed the following:
- Loss of consciousness of approximately 30 minutes or less.
- After 30 minutes, an initial Glasgow coma scales score of 13 ñ 15.
- Post Traumatic Amnesia not greater than 24 hours.
- Brain Injury, Traumatic:
- Damage to living brain tissue caused by an external, mechanical force. The specific disabling effects may be physical, visual, aural, perceptive/cognitive or emotional in nature.
- Brain Plasticity:
- The ability of intact brain cells to take over functions of damaged cells; plasticity diminishes as we get older.
- Brain Scan:
- An imaging technique in which a radioactive dye is injected into the blood stream and then pictures of the brain are taken to detect tumors, hemorrhages, blood clots, abscesses or abnormal anatomy.
- Brain Stem/Mid Brain:
- Nerve tissues below the main hemisphere at the top, where it connects to the spinal cord. Controls bodily functions such as consciousness, wakefulness, breathing and heart rate.
- Burr Hole:
- A hole drilled in the skull.
C
- Cerebellum:
- The portion of the brain (located at the back) which helps co-ordinate movement.
- Cerebral Hemispheres:
- The two side-by-side halves of the Cerebrum
- CSF Fluid:
- Clear, colourless fluid found in the spaces inside and around the brain and spinal cord.
- Cerebrum:
- The large walnut-like part of the brain, which is divided into two hemispheres (right and left). The different areas are called lobes (frontal, temporal, partietal and occipital).
- Closed Head Injury:
- Damage to the brain where there is no penetration from the scalp or skull through to the brain tissue. Often there is no injury to scalp or skull.
- Cognitive Abilities:
- Mental abilities such as thinking, remembering, planning, understanding, concentration and use of language.
- Coma:
- A state of unconsciousness from which the patient cannot be awakened or aroused, even by powerful stimulation; lack of any response to oneís environment. Defined clinically as an inability to follow a one-step command consistently and can be measured by the Glasgow Coma Scale that allows a grading of the coma by observation of eye opening, limb movements and speech.
- Concrete Thinking:
- A style of thinking in which the individual sees each situation as unique and is unable to generalise from similarities between situations.
- Confabulation:
- Verbalisation about people, places or events with no basis in reality.
- Contracture:
- Joints and muscles that are not used regularly, quickly become stiff, rendering them resistant to stretching. Eventually the joints become fixed, restricting movement and can be released only by surgery.
- Cranium:
- The bony skull (intracranial ñ inside the skull).
- CT Scan:
- A large doughnut shaped machine which is an x-ray camera that takes pictures of a personís brain in slices. It can pinpoint problem areas, especially bruises and blood accumulation, which can help determine if surgery is required.
D
- Diffuse Axonal Injury:
- Widespread injury to cells in many areas of the brain other than in one specific location.
- Diplopia:
- Double vision.
- Disinhibition:
- Difficulty in controlling urges and impulses to speak, act or show emotions.
- Disorientation:
- Not knowing where you are, who you are or the current date/year. Professionals often speak of a "normal" person as being oriented in person, time and place.
- Dysarthia:
- Difficulty in forming words or speaking them due to slowness, weakness or unco-ordination of tone of muscles.
- Dysphagia:
- Difficulty in swallowing.
E
- Edemia:
- Swelling of the brain.
- EEG (Electro-encephalogram):
- A procedure that uses electrodes on the scalp to record the electrical activity of the brain. Used for detection of epilepsy, coma and brain death.
- Embolism:
- Sudden blockage of an artery by a clot.
- Emotional Lability:
- Exhibiting rapid and drastic changes in emotional state (laughing, crying, anger) that are inappropriate.
- Executive Functions:
- Planning, organising, problem solving, sequencing, prioritising, self-monitoring, controlling or altering behaviour and judgement.
F
- Flaccid:
- Lacking normal muscle tone; limp.
- Flexion:
- Bending a joint.
- Frontal Lobe:
- The part of each cerebral hemisphere primarily concerned with planning and organising, attention and the control and regulation of behaviour and emotion.
- Frustration Tolerance:
- The ability to persist in completing a task despite apparent difficulty. Individuals with a poor frustration tolerance will often refuse to complete tasks which are the least bit difficult. Angry behaviour, such as yelling or throwing things, while attempting a task is also indicative of poor frustration tolerance.
G
- Gastrostomy:
- A tube that us inserted through a surgical opening into the stomach, which is used to administer foods, fluids or medication when swallowing is impossible.
- Glasgow Coma Scale:
- A numerical sale given to head-injured patients, immediately following the injury, to measure the degree of unconsciousness. Scores run from a high of 15 to a low of 3. Persons are considered to have sustained a "mild" brain injury when the score is between 13-15. A score of 9-12 is considered to reflect a "moderate" brain injury, where a score of 8 or less reflects a "severe" brain injury.
H
- Haematoma:
- Blood clot ñ when the brain is bruised it may bleed. The collection of blood, which forms into "pods" or "clots" is known as an "intercerebral haematoma". When the blood collects between the brain and the dura membrane, it is called a "subdural haematoma". These clots of blood press against the brain tissue and cause damage.
- Haemorrhage:
- Blood loss; bleeding.
- Hemianopia:
- Visual field loss to one side.
- Hemiparesis:
- Loss of power/weakness in one side of the body.
- Hydrocephalus:
- Accumulation of cerebrospinal fluid within the brain.
- Hypoxia:
- Insufficient oxygen to body tissues.
I
- Infarct:
- An area where brain cells have died as a result of loss of blood supply.
- Intracranial Pressure (ICP):
- Pressure inside the skull
- Impulsive Control:
- Persons who act or speak without first considering/thinking about the consequences are viewed as having poor impulse control. Refers to an individualís ability to curb inappropriate verbal or motor responses when undertaking an activity.
- Intravenous:
- Tubing which is inserted into a vein, which fluids and medication can be administered.
L
- Lability:
- Notable changes in an individualís emotional health/wellbeing e.g. uncontrolled laughing or crying.
- Limbic System:
- A group of structures connected to the hypothalamus overriding memory, emotions and basic drives, including sex drive.
- Locked-In Syndrome:
- Results from disturbance of motor pathways in the ventral paths, usually when a loss of blood supply results with brain cells dying. This leaves the individual completely paralysed and mute, but able to received and understand sensory stimuli e.g. communication may be possible by code using blinking.
M
- MRI (Magnetic Resonance Imaging):
- The latest diagnostic device which combines computer technology and physics. The MRI uses radio frequency and a magnet to chart electrical charges created in the brain. It then converts them into computerised, detailed pictures of the brain. MRIís can present both specific and general nerve damage.
- Memory, Immediate:
- The ability to recall numbers, pictures or words immediately following presentation. Individuals with immediate memory problems have difficulty learning new tasks because they cannot remember instructions.
- Memory, Long Term:
- This refers to recall thirty minutes or longer following presentation. This requires the individual to retain and retrieve information, which exceeds the limit of short-term memory.
- Memory, Short Term:
- Primary or "working" memory; its contents are in conscious awareness. A limited capacity system that holds up to 7 chunks of information over periods of 30 seconds to several minutes, depending upon the individualís attention to the task.
- Muscle Tone:
- The muscleís readiness to contract or the degree of resistance to movements in a limb or group if muscles. Muscle tone can be normal, increased or decreased.
N
- Nasogastic Tube:
- A fine tubes which is passed down through the nose and throat into the stomach for giving liquid food and pureed meals. This is used if there are swallowing difficulties.
- Neglect:
- Paying little or no attention to a part of the body.
- Neologism:
- Nonsense or made-up word. The individual affected does not realise that the word does not make any sense.
- Nystagmus:
- Jerking of the eyes, which is usually a result of damage to the brain stem.
O
- Occipital Lobe:
- The part of each cerebral hemisphere primarily concerned with perception and interpretation of visual information.
- Oedema:
- Excess fluid in tissues, causing swelling.
- Open Head Injury:
- This injury results where there is a penetration of the scalp and skull through to brain tissue.
- Orientation:
- Awareness of oneís environment and/or situation, along with the ability to use this information appropriately in a functional setting.
P
- Paralysis:
- Loss of ability of muscles to contract.
- Paraplegia:
- Paralysis of the lower limbs. More likely to result from damage to the spinal cord than from a head injury.
- Parietal Lobe:
- The part of each cerebral hemisphere primarily concerned with the perception and interpretation of sensation and movement.
- Perception:
- The ability of make sense of what one sees, hears, feels, tastes or smells.
- Perseveration:
- Involuntary prolonged repitition of words or actions.
- P.V.S. (Persistant Vegetative State):
- A long-standing condition in which the individual utters no words and does not follow commands or make any response that is meaningful.
- Photophobia:
- Abnormal sensitivity of the eyes to light.
- Post-Concussion Syndrome:
- Symptoms which occur following a mild head injury which may persist for days, weeks or months.
- PTA (Post-Traumatic Amnesia):
- Inability to remember continuous events, after a blow to the head which causes an alteration of consciousness, even when the individual is apparently awake.
R
- Reasoning, Abstract:
- Mode of thinking in which the individual recognises a phrase that has multiple meaning and selects the meaning most appropriate to a given situation. The term "abstract" refers to concepts not readily apparent from the physical attributes of an object or situation.
- Reasoning, Concrete:
- The ability to understand the literal meaning of a phrase.
- Rehabilitation:
- An active process by which a disabled person realises his/her optimal physical, mental and social potential.
- Retrograde Amnesia:
- Inability to remember events that happened for a period before a blow to the head.
S
- Seizure:
- An uncontrolled discharge of nerve cells which may spread to other cells nearby or throughout the brain. It usually lasts for a few minutes it may be associated with loss of consciousness, loss of bowel and bladder control and tremors. Can also cause aggression or other behavioural changes.
- Sequencing:
- Reading, listening, expressing thoughts, describing events or contracting muscles in an orderly and meaningful manner.
- Shunt:
- A device to remove excess fluid or divert blood. It is u-shaped plastic tube with a valve, which opens with pressure and can be inserted between an artery and a vein, bypassing the capillery network.
- Spacticity:
- Having stiffness or weakness of the limbs and occurs from higher nervous functioning.
- Spatial Ability:
- Ability to perceive the construction of an object in both two and three dimensions. Spatial ability has 4 components:
- The ability to perceive a static figure in difficult positions.
- The ability to interpret and duplicate the movements between various parts of a figure.
- The ability to perceive the relationship between an object and a persons own body sphere.
- The ability to interpret the personís body as an object in space.
- Spontaneous Recovery:
- Recovery which occurs as damage to body tissues heals. This type of recovery occurs with/without rehabilitation and it is difficult to know how much improvement is spontaneous and how much is due to rehabilitative interventions.
- Subdural:
- Beneath the dura (tough membrane) covering the brain and spinal cord.
T
- Temporal Lobes:
- There are 2 temporal lobes, one on each side of the brain located approximately at the same level of the ears. These lobes allow a person to tell one smell from another and one sound from another. They also help to sort out new information and are responsible for short-term memory.
Right Lobe: Mainly involved in visual memory e.g. memory for pictures and faces. Left Lobe: Mainly involved in verbal memory e.g. memory for words and names. - Tracheotomy:
- A small operation, with local anaesthetic which is performed if there is an obstruction of the airways. Assists with breathing.
- Traumatic Brain Injury:
- Damage to the brain and/or brain stem due to an external causation e.g.:
- Road traffic accidents
- Domestic and Industrial injuries
- Sporting injuries
- Assaults
- Tremor:
- Regular repetitive movements which may be worse either at rest or on attempted movement.
U
- Unilateral Neglect:
- Paying little or no attention to things, pertaining to only one side. This usually occurs on the side opposite the location of the injury. In extreme cases, the person may not bathe, dress or acknowledge one side of the body.
V
- Ventilator:
- Also called a respirator. A machine that pumps oxygen into the lungs when they are not working efficiently. This encourages quiet breathing and the prevention of coughing and straining.
- Vestibular:
- System in the middle ear which senses movement. Injury can lead to dizziness.
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