ABPMR Brain Injury Medicine key terms

A bedside score from 3 to 15 that sums eye opening, verbal response, and motor response. It grades depth of impaired consciousness after acute brain injury and guides triage, monitoring, and prognosis.

The period after brain injury when forming and storing new memories is impaired. Its duration reflects injury severity and predicts functional outcome. It is measured with orientation and memory tools such as the Galveston Orientation and Amnesia Test.

A group of conditions with severely impaired awareness after brain injury, including coma, unresponsive wakefulness syndrome (formerly vegetative state), and minimally conscious state. Bedside examination of wakefulness and reproducible awareness distinguishes them.

An eight-level descriptive scale of cognitive and behavioral recovery after brain injury, ranging from no response to purposeful, appropriate behavior. Teams use it to communicate functioning, set rehabilitation expectations, and plan transitions.

A mild traumatic brain injury causing transient physical, cognitive, or emotional symptoms, usually with normal structural imaging. Management emphasizes education, symptom-guided gradual activity, and a stepwise return to school, work, or sport.

Shearing injury of white-matter tracts caused by rotational acceleration and deceleration forces. It often produces prolonged unconsciousness out of proportion to initial CT findings and is better detected on MRI.

Bleeding inside the skull after trauma, including epidural, subdural, subarachnoid, and intraparenchymal hematomas. Expanding collections can cause herniation and need urgent neurosurgical evaluation, especially with anticoagulation.

Reduced awareness of one's own deficits after brain injury, rather than simple denial. It undermines rehabilitation participation, safety judgment, and driving decisions, and often improves slowly with feedback and structured experience.

Impaired planning, organization, initiation, self-monitoring, and problem solving after injury to frontal and connected networks. It can limit independence more than memory loss or weakness and responds to external structure and strategy training.

A temporary recovery phase of restlessness, aggression, disinhibition, and emotional lability after brain injury. Clinicians first look for pain, constipation, infection, and environmental triggers before using sedating medications.

Reduced motivation and goal-directed behavior without prominent sadness or tearfulness. It is common after frontal or subcortical injury, can be mistaken for depression, and may respond to structured routines and activating medications.

Persistent low mood, loss of interest, and neurovegetative symptoms after brain injury. Risk rises with prior mood disorder and limbic injury; it reduces rehabilitation participation and quality of life and warrants active treatment.

Involuntary laughing or crying that is exaggerated or incongruent with the person's mood. It reflects disrupted corticobulbar pathways and can be treated with dextromethorphan-quinidine, selective serotonin reuptake inhibitors, or other agents.

An acute, fluctuating disturbance of attention and awareness triggered by medication, infection, pain, or metabolic problems. In brain-injured patients it is a medical emergency that slows recovery and increases mortality.

Persistent somatic, cognitive, and emotional symptoms after mild traumatic brain injury. Risk is higher with preexisting anxiety or depression, early severe symptoms, and litigation or compensation, and recovery is usually gradual.

Episodes of rapid heart rate, high blood pressure, fast breathing, fever, sweating, and abnormal posturing after severe brain injury. Diagnosis is clinical and requires excluding other causes before using scheduled and trigger-based medications.

Recurrent unprovoked seizures starting more than one week after traumatic brain injury. Risk increases with cortical contusion, intracranial hematoma, penetrating injury, and seizures in the first week.

Short-term antiseizure medication after severe traumatic brain injury to prevent early seizures. It does not prevent later epilepsy and is usually limited to about seven days to reduce adverse effects.

Abnormal bone formation in soft tissue, commonly around the hips and elbows after severe brain injury. It causes swelling, pain, and loss of joint motion and is confirmed with imaging and alkaline phosphatase trends.

A velocity-dependent increase in muscle tone caused by hyperexcitable stretch reflexes after upper motor neuron injury. It can interfere with hygiene, positioning, and function, and is treated with therapy, medication, and chemodenervation.

Ventricular enlargement from impaired cerebrospinal fluid absorption or flow after brain injury. It may cause headache, cognitive decline, gait disturbance, and incontinence, and can improve after shunt placement.

Hormone deficiency after traumatic brain injury, including growth hormone, gonadotropin, thyroid, and cortisol deficits. It can cause fatigue, mood change, weight change, and delayed recovery, so screening is recommended in selected patients.

Difficulty swallowing after brain injury that can lead to aspiration, pneumonia, dehydration, and malnutrition. Bedside screening and instrumental studies such as videofluoroscopy guide diet texture, supervision, and therapy.

Measures to prevent deep vein thrombosis and pulmonary embolism in immobilized brain-injured patients. Mechanical devices and anticoagulants are chosen by balancing clot risk against bleeding from intracranial injury.

Structured therapy that targets attention, memory, executive function, and social communication using strategy training, practice, and environmental supports. The goal is improved everyday functioning rather than restoration of lost brain tissue.

An eighteen-item measure of self-care, mobility, and cognition scored by the amount of assistance required. It tracks rehabilitation progress, supports discharge planning, and is used in outcome and payment systems.

Methods and devices, from picture boards to eye-gaze computers, that supplement or replace speech for people with severe communication impairment. Early introduction reduces frustration and supports participation in care.

A rehabilitation approach that restrains the less affected arm while intensively training the more affected arm. It addresses learned nonuse and is used for hemiparesis after stroke or brain injury.

Coordinated services such as work assessment, job modification, retraining, and supported employment that help a person with brain injury return to competitive or sheltered work.

The brain's ability to reorganize connections and function in response to experience, learning, or injury. It underpins rehabilitation and is generally greater in young children than in older adults.

Inflicted brain injury in infants and young children from shaking or impact. Suspicious findings include inconsistent history, retinal hemorrhages, apnea, and fractures; clinicians must report under mandatory reporting laws.

Brain injury in older adults, most often from falls and frequently complicated by anticoagulation, frailty, and comorbid disease. Outcomes are worse, and rehabilitation must address polypharmacy, delirium risk, and cognitive decline.

A graduated plan for a student's return to school after concussion or brain injury. It uses rest breaks, reduced workload, and stepwise increases in cognitive demand while monitoring symptoms.

A patient's ability to understand relevant information, appreciate consequences, reason about options, and communicate a choice. It is assessed for a specific decision and is distinct from legal competence.

Irreversible loss of all brain function, including the brainstem. It is determined by a protocol showing coma, absent brainstem reflexes, and apnea despite adequate stimulation, and is distinct from disorders of consciousness.

A court-appointed arrangement in which one adult makes decisions for another found unable to do so. It should be the least restrictive option and guided by the person's known values and wishes.

Methods that detect invalid effort, feigned impairment, or exaggerated symptoms during neuropsychological assessment. They are important in medicolegal and disability evaluations, but poor performance does not by itself prove malingering.