A GLOSSARY OF TERMS

Acceleration-deceleration injury

This is when the head is driven forwards and backwards with great force, causing the brain to bounce back and forth within the skull.

Acquired brain injury

Often shortened to ‘ABI’. The ‘acquired’ part means that the person wasn’t born with their injury – it is the result of an accident or illness that has happened later.

Acute

This is the period of time when any kind of illness is at its most serious and dangerous.

Acute pain

Could be mild and last just a moment, or it might be severe and last for weeks or months. In most cases, acute pain does not last longer than six months, and it disappears when the underlying cause of pain has been treated or has healed. Unrelieved acute pain may be categorised as chronic pain.

Analgesia

In short, painkillers. Analgesia is medicine given to reduce pain or prevent pain developing. It can take the form of a liquid, tablets, suppositories or a drip.

Anoxia (the most severe form of hypoxia)

This happens when the brain is completely deprived of oxygen: in hypoxia the brain doesn’t get enough oxygen.

This can happen through near drowning and asphyxiation (which is where someone cannot breathe at all), among other reasons.

Sometimes this kind of acquired brain injury is called hypoxic brain injury.

Anterior cord syndrome

An incomplete spinal injury caused by damage to the front of the spinal cord resulting in impaired movement, touch, pain, and temperature sensations below the point of injury.

Anticonvulsant

Medicine used to control seizures or fits.

Antiemetic

Medicine given to prevent nausea or vomiting.

Aphasia

The change, or loss, in language function due to an injury.

Apraxia

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

Assessments

These are the different tests and procedures staff might carry out. The aim is to establish what is going on and how best to deal with it.

Ataxia

Difficulty co-ordinating muscle movements.

Atraumatic acquired brain injury (sometimes called non-traumatic acquired brain injury)

To describe something as serious as acquired brain injury as ‘non-traumatic’ may seem strange but the term is used to separate atraumatic injuries from those caused by a blow (or trauma) to the head.

One way of thinking about it is to say an atraumatic acquired brain injury is the result of things going on inside the body, such as a stroke or meningitis.

Bilateral

Refers to both sides of the body or extremities on both sides.

Bone flap removal/craniotomy

A surgical procedure where a piece of the skull is removed to allow the brain room to swell and thereby relieve increased intracranial pressure.

Brachialgia

A technical term for arm pain. It is used when the pain is thought to be due to a problem with the nerves, most frequently a compressed or pinched nerve in the neck.

Brown-Sequard syndrome

Occurs when one side of the spinal cord is damaged in an incomplete spinal cord injury. This causes a loss of movement but preserved sensation on one side of the body, while the other side of the body has loss of sensation but preserved movement.

Burr hole

A hole made in the skull in surgery to relieve increased intracranial pressure.

Cannula/drip

A small tube placed through the skin and into a vein. Usually in a hand or arm (but sometimes in the foot or scalp of small children). Used to give medicine, drain fluid or to insert a medical instrument.

When medication and fluid is given this way, it is described as being given ‘intravenously’.

Carpal Tunnel Syndrome

A painful disorder in the hand caused by inflammation of the median nerve in the wrist bone.

Cauda equina syndrome (or lesion)

Characterised by injury to the nerves located between the first and second lumbar region of the spine, resulting in partial or complete loss of sensation.

Causalgia

Severe burning pain in a limb caused by injury to a peripheral nerve now know as CRPS-II

Central cord syndrome

An incomplete spinal cord injury following damage to the centre of the spinal cord. This results in loss of function in the arms, although some leg movement is usually preserved.

Cerebrospinal fluid (CSF)

The fluid made by our brains which makes its way around the brain and the spinal cord: it bathes the brain and spinal cord and fills the ventricles. The brain effectively floats in this fluid and is thereby cushioned. A lumbar puncture (spinal tap) is used to draw CSF.

Cervical spine

The cervical spine (neck) is delicate – housing the spinal cord that sends messages from the brain to control all aspects of the body – while also remarkably flexible, allowing movement in all directions, and strong.

Chronic

An illness, pain or condition that persists for a long time or constantly recurs.

Chronic pain

Whereas acute pain is a normal sensation that alerts us to possible injury, chronic pain is very different in that it persists, often for months or even longer.

Complex regional pain syndrome (CRPS)

A chronic pain condition most often affecting one of the limbs (arms, legs, hands, or feet), usually after an injury or trauma to that limb.  CRPS is believed to be caused by damage to, or malfunction of, the peripheral and central nervous systems.

Clinical psychology/clinical psychologist

The aims of clinical psychology are wide-ranging.  These professionals may give emotional support as they go through stressful times such as a medical procedure. They might help with emotional difficulties or give advice about how someone can talk about their condition and their feelings with friends and family.

Closed head injuries

The most common kind of head injury. The ‘closed’ means simply that there isn’t a break in the skull, and the brain is not exposed.

Coccyx

The coccyx is sometimes called the tail bone because it’s considered the remnant of the full tail of our ape-like ancestors.

Cognitive functioning/cognition/cognitive

These terms are all taking about the processes that go on in our minds. Our cognitive function is the way we think, understand the world around us, make judgements, and reason.

Cognitive fatigue

This is where the functions described above ‘slow down’ and become tired because the patient is fatigued.

Compression fracture

A collapse of a vertebra. It may be due to trauma or due to a weakening of the vertebra (compare with burst fracture). This weakening is seen in patients with osteoporosis or osteogenesis imperfecta, lytic lesions from metastatic or primary tumors, or infection.

Contact sports

Any sporting activity where there is a risk of impact to the head. Examples might be: rugby, football, boxing or horse riding.

Concussion

This literally means ‘to be shaken violently’ and is usually caused by a blow to the head. A concussion may cause a temporary loss of consciousness. But there does not have to be any loss of consciousness to have concussion.
A concussion may result in someone feeling dazed or confused. A concussion may result in a mild or moderate brain injury.

Consultant

A senior doctor who will be a specialist in their field.

Contrast

The dye injected before some X-rays, CT and MRI scans.

Contusion

These are injuries that bruise part of the brain.

Convulsion

A seizure or fit.

Coup-countrecoup

These are contusions (see definition above) that are at the place of the impact, but also on the opposite side of the brain. This is where the force of the impact causes the brain to move in the skull and to hit the other side of the skull.

Craniotomy/bone flap removal

This is where the skull is opened to relieve pressure that has built up. Sometimes, a piece is removed from the skull to relieve pressure.

CRPS-I (previously called reflex sympathetic dystrophy syndrome).

A term for patients without confirmed nerve injury

CRPS-II (previously called causalgia)

The term used for patients with confirmed nerve injuries

Crush or compression fracture

A vertebral bone in the spine that has decreased at least 15 to 20% in height due to fracture.

CT scan (computerised tomography)

A CT scanner does a similar job to an X-ray machine, but at a much more advanced level. Rather than sending out just one ray, the CT scanner sends lots of beams from different directions, building up a detailed picture of the brain.

Discectomy

Is the surgical removal of herniated disc material that is pressing on a nerve root or the spinal cord. The procedure involves removing the central portion of an intervertebral disc, the nucleus pulposus, which causes pain by stressing the spinal cord or radiating nerves.

Discharge

This is when the healthcare professionals have decided a patient is safe to go home.

Discharge planning meeting

The aim of these meetings is to make sure that the patient has a ‘care plan’ on leaving hospital. This is a plan of action to set out what kind of care may be needed and who will provide it.

Disinhibition

Some people with acquired brain injury can behave in a way that is described as ‘disinhibited’. This means that they may act impulsively, or in a way that suggests they haven’t thought about what those around them might think.

Drip/cannula

A small tube that’s placed through the skin and into the vein. It’s usually in a hand or arm (but sometimes in the foot or scalp of small children). It might be used to give medicine, drain fluid or to insert a medical instrument.
When medication and fluid is given this way, it is described as being given ‘intravenously’.

Dysphagia

When the muscles we use for swallowing become weak or uncoordinated and a patient can no longer swallow. This might mean a patient has to be fed using a special tube.

Educational, Health and Care plans

If a child’s needs are significant and complex and require a level of support that is at a higher level than the school can meet, it may be decided with their carers that a request is made for Education, Health and Care Needs Assessment which can lead to a Educational, Health and Care plan (EHCP).

Educational psychology/educational psychologist

This branch of psychology looks at the way children learn, and their individual strengths and difficulties. As with all children, the broad aim for those with ABI is to support those who may be experiencing problems in their education.

Extra-ventricular drainage (EVD)

This is a system used to measure the production of cerebrospinal fluid, or to relieve pressure within the brain by draining off fluid.

Family therapy

This approach reaches beyond an injured child to include his or her family. A brain injury can result in enormous disruption to the family routine and the way its members relate to one another. The aims for each family will be very different. Broadly speaking, family therapists help family members to help each other.

Fits/seizures

Seizures are caused when there’s a problem with the tiny electrical signals that run around our brains. Fits and seizures may take the form of a sudden loss of consciousness, a change in the state of consciousness or uncontrollable shaking in the body.

Focal damage

This is an injury to a specific part of the brain. This is compared to a ‘diffuse’ injury which is more widespread and affects different parts of the brain.

Glasgow Coma Scale (GCS)

This is a form of assessment healthcare professionals use to get an understanding of a patient’s consciousness. A patient might be asked questions like: “can you tell me your name?”, “Would you wiggle your toes?”.

GP

Your general practitioner is your family doctor. These healthcare professionals refer their patients to more specialised services and manage most medication prescriptions.

HDU – a High Dependency Unit

This is a unit at the hospital for people who need a high level of care.

Health visitor

A healthcare professional who visits patients and their families at home to offer support.

Hemiparesis

Weakness in the muscles of the face, arm and leg on one side of the body. It is where someone has difficulty moving this side of the body.

Hemiplegia

Paralysis in the muscles of the face, arm and leg on one side of the body. It is where someone cannot move this side of the body.

Hydrocephalus

This happens when the brain’s cerebrospinal fluid builds up inside the ventricles of the brain. This will be because a blockage has prevented the fluid from flowing normally.  Ventricles are the small cavities within the brain that are filled with cerebrospinal fluid.

Hypoxia/hypoxic acquired brain injury

This happens when the brain doesn’t get enough oxygen, or it is completely deprived of oxygen.

This can happen through near drowning and asphyxiation (which is where someone cannot breathe at all), among other reasons.

IEP – an Individual Education Plan

This is an education plan teachers will set out which has been tailored to a child.

Impairment

If something is ‘impaired’ it is weakened or diminished. You may hear some professionals talk about a patient’s ‘impairments’. These are the things they can’t do as well as a result of their injury.

Infections or metabolic disorders

There are many different types of infections. Metabolic changes are a chemical or biological reaction in the body that can affect brain functioning.  An example of this might be when a virus attacks the brain, causing injury to its tissue.

Intervention

Although it sounds dramatic, intervention is just a way to describe an outside influence on someone’s behaviour. A therapy, such as physiotherapy, is a form of intervention.

Intracranial pressure/increased intracranial pressure

The skull is a solid box, which is almost fixed in size by the time we are 18 months old. When the brain swells or bleeds the result is that there is more pressure inside this solid box. This is raised intracranial pressure. If there are more fluids in this small space, they can push on the brain and cause damage.

Intracranial haemorrhage

Bleeding in the brain. This can cause difficulties because the brain can be deprived of blood, which can damage tissue. The blood itself can also damage brain tissue.

Intravenously

When medicines or fluids are given through a small tube that’s placed through the skin and into the vein. It’s usually in a hand or arm (but sometimes in the foot/scalp of small children.

The tube might be called a cannula or a drip.

Laminectomy

Surgery that creates space by removing the back part of the vertebra that covers your spinal canal known as the lamina. Also known as decompression surgery, laminectomy enlarges the spinal canal to relieve pressure on the spinal cord or nerves

Level of consciousness

At its most simplest, this is how ‘awake’ and alert somebody is. It is also how aware somebody is of their surroundings.

Liaison nurse specialist

A nurse who specialises in supporting the injured person and their families. They might speak with local agencies like school nurses and social workers on behalf of a family.

Ligament

The fibrous connective tissue that connects bones to other bones

Local authority

Your local elected council, which may be a county council or a city council. If you live in London, it may be a borough council.

Lumbar Spine

Refers to the lower back, where the spine curves inward toward the abdomen. It starts about five or six inches below the shoulder blades, and connects with the thoracic spine at the top and extends downward to the sacral spine.

Multidisciplinary/multidisciplinary approach

This is when different professionals with different specialisms are involved in the care or rehabilitation of an injured person and work together.

Music therapy/music therapist

By improvising music and taking turns to make noise on instruments (or even singing), an injured person can build on their ability to interact. It’s less about developing musical ability and more about helping a person take turns and make choices.

MRI scan (Magnetic Resonance Imaging)

Instead of X-rays, the MRI scanner uses magnetic and radio waves to build up a picture of the brain.

MVTA

Abbreviation for a Motor Vehicle Traffic Accident (see RTA and RTC).

Named nurse

A nurse who has been specifically named to take care of a patient.

Negligence

A failure to exercise the care that a reasonably prudent person would exercise in similar circumstances. The area of tort law known as negligence involves harm caused by carelessness rather than intentional harm.

Nerve root damage

Nerve root pain comes from a nerve in the spine. Nerves carry messages about sensations and control of muscles and so disorders of nerves can cause pain, numbness, increased sensitivity or weakness of muscles. The pain is often felt in the area of the body supplied by that nerve. It is common for the leg nerves and arm nerves to be affected.

Neurologist

A doctor who specialises in the brain (and the rest of the nervous system) and its disorders.

Neuro obs

The observations carried out to find out how the brain is working. Healthcare professionals might check temperature, pulse, pupil reaction, co-ordination, limb strength and somebody’s awareness of their surroundings.

Neuropsychologist

A psychologist who is a specialist in the brain. Usually involved after the initial treatment process, neuropsychologists look at the way we think and how the brain is recovering.

Neurosurgeon

A surgeon who specialises in performing surgery on the brain.

Neurosurgery

Surgery on the brain.

Non-traumatic acquired brain injury (sometimes called atraumatic acquired brain injury)

To describe something as serious as acquired brain injury as ‘non-traumatic’ may seem strange. But the term is used to separate atraumatic injuries from those caused by a blow (or trauma) to the head.

Objects of reference

If a patient has trouble communicating, therapists might use an ‘object of reference’. The idea is that a particular meaning or activity is attached to a particular object – perhaps a picture of a meal might be a message that it’s dinner time.

Observation

You may have heard doctors say someone is being kept in for observation. This is where healthcare staff will monitor and keep an eye on a patient.

Occupational therapy/occupational therapist/OT

Occupational therapy aims to support a patient with everyday tasks. Cleaning one’s teeth or getting dressed is made up of a sequence of tasks. Occupational therapists (or OTs) help people with this kind of activity.

Occupational Therapist (OT) – The member of the rehabilitation team who helps maximize a person’s independence.

Occupational Therapy (OT) – Structured activity focused on activities of daily living skills (feeding, dressing, bathing, grooming), arm flexibility and strengthening, neck control and posture, perceptual and cognitive skills, and using adaptive equipment to facilitate ADL’s.

Oedema

Is the medical term for swelling.

Open head injury

The ‘open’ means that the skull is cracked and the brain is exposed. This might have happened in some kind of collision or impact.

Healthcare professionals make the distinction between open and closed injuries. The ‘closed’ means simply that there isn’t a break in the skull, and the brain is not exposed.

Ophthalmologist

This is a doctor who is an eye specialist.

Orthopaedic surgeon

A doctor who specialises in the treatment of bones.

Paediatric

This means ‘relating to children’. So a ‘paediatric brain injury’ is one that has affected a child.

Paediatrician

A specialist in children’s healthcare.

Paediatric neurologist

A neurologist specialises in the brain and the rest of the nervous system. So a paediatric neurologist specialises in these things in children.

Paraplegia

Refers to impairment of loss of motor and/or sensory function in the thoracic, lumbar or sacral (but not cervical) segments of the spinal cord, secondary to damage of neural elements within the spinal canal. With paraplegia, arm functioning is spared, but, depending on the level of injury, the trunk, legs, and pelvic organs may be involved. There are some types of paralysis involving the legs that are described by the impairment they cause.

Paraplegic

One who has loss of function below the cervical spinal cord segments, wherein the upper body retains most function and sensation.

Paresis

Weakness of voluntary muscle movement or slight paralysis.

Physiotherapy/physiotherapists

As well as manipulating the muscles to encourage greater movement and flexibility, physiotherapy may take the form of specific exercise, or managing posture. Each patient’s targets in physiotherapy will be very different.

Paediatric Intensive Care Unit (PICU)

A specialised ward for children who need a high level of care.

Phantom limb pain

Pain appearing to come from where an amputated limb used to be – is often excruciating and almost impossible to treat.

Planning meeting/discharge planning meeting

The aim of these meetings is to make sure the patient has a ‘care plan’ on leaving hospital. This is a plan of action to set out what kind of care is needed and who will provide it.

Play therapy/play therapist

Sometimes children find it difficult to talk through their problems and concerns in the same way an adult might. Play therapy gives children a private, confidential space to work through anything that’s troubling them.

Posterior cord syndrome

An incomplete spinal cord injury from damage to the back of the spinal cord often enables you to maintain good muscle power, pain, and temperature sensation, but leaves you experiencing poor co-ordination.

Prophylactic analgesia

Medicine given at regular intervals to prevent pain from developing. It might take the form of liquid, tablets, suppositories or through a drip.

Post-concussion syndrome

It is possible to experience post-concussion syndrome weeks or months after a mild head injury. These might be headaches, dizziness, memory problems, or behavioural or communication difficulties. If you experience any of these symptoms after sustaining a head injury you should see a doctor as soon as possible.

Post-traumatic amnesia (PTA)

Amnesia is where we lose our memory, or become disorientated or confused. People who have experienced any kind of trauma may have this kind of experience.

Prolapsed disc

A slipped disc – known as a prolapsed or herniated disc – occurs when one of the discs that sit between the bones of the spine (the vertebrae) is damaged and presses on the nerves. This can cause back pain and neck pain, as well as symptoms such as numbness, a tingling sensation, or weakness in other areas of the body.

Quadriparesis

Partial loss of function all four (4) extremities of the body.

Quadriplegia

An American term for 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.

Referral

This is where one healthcare professional puts in a request for the services of another healthcare professional or service. If you had difficulties with your bones, your GP would refer you to a bone or orthopaedic specialist.

Radiology

This is the department in a hospital where X-rays or other radiation techniques are used.

Reintegration

The process of a settling back into a previously familiar setting such as work or school.

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.

Reflex sympathetic dystrophy (RSD)

is a clinical syndrome of variable course and unknown cause characterized by pain, swelling, and vasomotor dysfunction of an extremity often the result of trauma or surgery.

RTA

Abbreviation for a Road Traffic Accident more commonly now called a Road Traffic Collision or RTC or Motor Vehicle Traffic Accident MVTA

RTC

Abbreviation for a Road Traffic Collision sometimes called a Motor Vehicle Traffic Accident MVTA both previously referred to as a Road Traffic Accident or RTA

Sacral

A large, triangular bone at the base of the spine and at the upper, back part of the pelvic cavity, where it is inserted like a wedge between the two hip bones. The sacrum consists of fused vertebrae.

SEN

Sometimes, the professionals you deal with might abbreviate Special Educational Needs to SEN.

Social workers

These professionals can be a key ally to families in difficult times. Their principal role is to make sure everyone in a family is managing, and being given the help and services they need.

Soft tissue injury (STI)

Damage of muscles, ligaments and tendons throughout the body. Common soft tissue injuries usually occur from a sprain, strain, a one off blow resulting in a contusion or overuse of a particular part of the body.

Spasticity

Hyperactive muscles that move or jerk involuntarily.

Speech and language therapy/speech and language therapists

Speech and language therapists help people to communicate after an acquired brain injury. They also help with dysphagia (difficulty swallowing).

Spinal fusion

major surgery, usually lasting several hours. There are different methods of spinal fusion. Bone is taken from the pelvic bone or from a bone bank. The bone is used to make a bridge between vertebrae that are next to each other.

Spontaneous bleeding

There are different reasons for bleeding within the brain.

One possibility is when there is a weakened blood vessel (an aneurysm). Another might be ateriovenous malformation, which is when the connection between veins and arteries isn’t as it’s supposed to be.

High blood pressure or rare bleeding disorders can also trigger bleeding.

Stroke

The brain needs blood in order to function properly. A stroke happens when the bloody supply to the brain is cut off or interrupted for some reason. Without blood, the cells in the brain start to die, and this is when an injury can occur.

Subdural haematoma

Caused when blood collects between the skull and the surface of the brain. The blood puts the brain under pressure, which can trigger a wide range of symptoms including vomiting (being sick), mental confusion and coma.

Tendon (or sinew)

A tough band of fibrous connective tissue that usually connects muscle to bone and is capable of withstanding tension.

Tetraplegia

(or Quadriplegia) is paralysis caused by illness or injury that results in the partial or total loss of use of all limbs and torso; paraplegia is similar but does not affect the arms. The loss is usually sensory and motor, which means that both sensation and control are lost.

Thoracic

Relating to the chest, vertebrae or spinal cord segments between the cervical and lumbar areas.

Traumatic brain injury (or TBI)

The result of an impact to the head. Examples might be a car accident or a fall.

Healthcare staff will make the distinction between this kind of injury and ‘atraumatic’ or non-traumatic brain injury, which is the result of something like meningitis or a brain tumour.

One way of thinking about it is to say traumatic brain injury is the result of things happening outside the body, such as a blow to the head. Non-traumatic brain injury is the result of things going on inside the body, such as a stroke or a lack of oxygen.

Traumatic spondylolisthesis

Refers to an anterior spinal fracture or slippage of one vertebra over another (in the front of the spine) often referred to as a ‘slipped disc’

Tumour

In relation to acquired brain injury, a tumour is a growth inside the skull. These can be either malignant or benign. These terms are defined in our section on non-traumatic injury.

Ventilator

A piece of medical equipment that helps with breathing in a person with impaired diaphragm function.

Ventricles

These are small cavities within the brain that are filled with cerebrospinal fluid.