Chapter 8: Traumatic Brain Injury Terminology and Concepts

Vocabulary flashcards covering the pathophysiology, mechanisms, classifications, secondary complications, assessment scales, and rehabilitation concepts of traumatic brain injury.

Primary damage

The initial mechanical injury sustained by the brain tissue at the immediate time of trauma.

Secondary damage

Pathological complications that develop after the initial event (such as cerebral edema and hematomas) that occupy space, raise intracranial pressure, and reduce cerebral blood flow.

Acceleration-deceleration injury

An injury caused by rapid movement followed by an abrupt halt, forcing the brain to move inside the skull.

Coup-contrecoup injury

An injury pattern in which the brain strikes the skull at the initial point of impact and then rebounds to strike the opposite side.

Closed head injury

An injury where the skull remains intact, but the brain is damaged by biomechanical forces that do not penetrate the skull.

Open head injury

An injury in which the skull is broken open and the brain is penetrated by an object, creating focal deficits and elevating the risk of infection.

Impact-based closed head injury

A trauma in which a moving object strikes the head, forcing the skull inward and compressing or bruising brain tissue directly beneath the site of impact.

Diffuse axonal shearing

The widespread breaking and stretching of neuronal connections across broad regions of the brain, commonly produced by rotational acceleration forces.

Ballistic trauma

A penetrating brain injury caused by a projectile breaking through the skull.

Increased intracranial pressure (ICP)

The elevation of pressure within the skull above normal levels, which can compress brain tissue and blood vessels and reduce cerebral blood flow.

Cerebral edema

Swelling of brain tissue following trauma that occupies additional intracranial volume and increases intracranial pressure.

Traumatic hydrocephalus

A condition in which the brain cannot reabsorb excess cerebrospinal fluid following a traumatic disruption of the fluid system.

Traumatic hemorrhage

Bleeding from intracranial blood vessels resulting from serious physical injury.

Hematoma

A gathering of blood outside a blood vessel following a hemorrhage that can expand and compress adjacent brain tissue.

Subdural hematoma

An accumulation of blood that collects between the dura mater and the arachnoid mater.

Epidural hematoma

An accumulation of blood that collects between the inner surface of the skull and the dura mater.

Post-traumatic epilepsy

Seizure activity occurring as a consequence of traumatic brain injury that can delay rehabilitation and potentially cause additional brain damage.

Craniotomy

A surgical procedure involving the temporary opening of the skull to provide access to relieve elevated intracranial pressure or evacuate a hematoma.

Shaken baby syndrome

A constellation of diffuse brain injury caused by violent shaking involving rotational and acceleration-deceleration forces, characterized by retinal hemorrhages, subdural hematoma, edema, and altered consciousness.

Barotrauma (Primary blast trauma)

Tissue injury to the brain, eyes, or air- and fluid-filled organs produced by intense, rapid air pressure changes from an explosive shockwave.

Secondary blast trauma

Injuries caused by flying debris, bomb fragments, and projectiles propelled outward by an explosion.

Tertiary blast trauma

Injuries that occur when the physical force of a blast wave displaces or throws the body into a structure, object, or the ground.

Quaternary blast trauma

Miscellaneous blast-related injuries and complications including burns, toxic gas exposure, smoke inhalation, dust exposure, or crush trauma.

Polytrauma

A profile characterized by multiple serious physical injuries across different body systems following a traumatic event, such as a blast.

Concussion

A complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces, which can occur without loss of consciousness.

Chronic traumatic encephalopathy (CTE)

A progressive degenerative brain disease associated with repetitive head impacts, developing over time and marked by memory loss, confusion, emotional lability, and aggression.

Ionic flux

The widespread and unregulated movement of ions across damaged cell membranes immediately following biomechanical injury.

Glucose hypermetabolism

An initial phase in the neurometabolic cascade where the brain rapidly burns glucose in an effort to restore ionic balance and homeostasis.

Glucose hypometabolism

A period following hypermetabolism where cerebral glucose utilization drops below normal, creating an energy crisis that impairs cognitive function.

Baseline cognitive testing

Neurocognitive assessment administered prior to exposure or an athletic season to provide an individualized comparison point following a suspected concussion.

Ataxia

Incoordination and impaired motor balance resulting from damage to the cerebellum.

Photophobia

Abnormal, painful oversensitivity to light.

Phonophobia

Abnormal, painful oversensitivity to sound.

Coma

A state of profound unconsciousness where a person cannot be awakened, remains unresponsive to sensory stimuli for more than six hours, and exhibits no wakefulness or purposeful activity.

Vegetative state

A condition in which wakefulness returns and minimal reflexive responses may appear, but the person lacks consciousness, cognition, and behavioral evidence of awareness.

Persistent vegetative state

A vegetative state that continues for longer than four weeks, defining duration rather than awareness level.

Minimally conscious state

An altered state characterized by inconsistent but distinct, reproducible behavioral signs of awareness and purposeful response to meaningful stimuli.

Locked-in syndrome

A condition where a patient is cognitively intact but nearly completely paralyzed, retaining voluntary control only over eye movements or blinking for communication.

Post-traumatic amnesia (PTA)

A state of memory impairment following traumatic brain injury that encompasses both retrograde and anterograde memory deficits.

Retrograde amnesia

Difficulty recalling memories and information that were acquired before the traumatic injury occurred.

Anterograde amnesia

The inability or reduced ability to form and retain new memories following a traumatic brain injury.

Glasgow Coma Scale (GCS)

A standard neurological rating tool that measures eye opening, verbal response, and motor response to describe level of consciousness.

Adelaide Coma Scale

A pediatric coma scale designed to assess consciousness while accommodating developmental and age-related differences in children.

Ranchos Los Amigos Levels of Cognitive Functioning Scale

A clinical rating system that tracks the characteristic patterns and stages of cognitive and behavioral recovery following a brain injury.

Agitated Behavior Scale

A standardized scale used to measure the level of agitation and track behavioral changes over time in brain injury patients.

Overt Aggression Scale

A behavioral assessment tool designed specifically to document and measure instances of verbal and physical aggression.

Spaced retrieval training

A cognitive rehabilitation technique in which meaningful information is presented and the patient is cued to recall it over increasingly longer intervals of time.

Restorative memory approaches

Rehabilitation methods aimed at directly exercising and improving underlying memory abilities through repetitive practice tasks.

Internal memory strategies

Cognitive techniques and mental actions—such as visualization, association, and rehearsal—employed to enhance memory encoding and retrieval.

External memory strategies

Physical devices and environmental aids—such as calendars, written checklists, smartphone reminders, and memory books—used to compensate for memory loss.