appendix 1 Outline Diagrams of the Brain
appendix 2 Glasgow Outcome Scale
appendix 3 Glasgow Coma Scale
appendix 4 Post Traumatic Amnesia

GCS
See GLASGOW COMA SCALE

GLASGOW COMA SCALE (See Appendix 3).
This scale is used throughout the westernised world to measure level of responsiveness and to define coma and severity of head injury.

GLASGOW OUTCOME SCALE
This scale is used throughout the westernised world and beyond to measure outcome of head injury. For a fuller description, see Appendix 2.

GOS
See GLASGOW OUTCOME SCALE

GRAND MAL
A form of EPILEPSY (qv) in which there is loss of consciousness and generalized convulsions.

GYRI (singular: GYRUS)
The convolutions which make up the surface of the brain. (See also SULCI).

HAEMATOMA
A collection of clotted blood. The expansion of a blood collection can rapidly cause severe brain damage and death. The great majority of those patients who are conscious after the initial blow but subsequently die ('talk and die' cases) have developed haematomas.

HEMIANOPIA (see also VISUAL FIELDS and HOMONYMOUS HEMIANOPIA).
A loss of part of the visual field so that half of the visual field in each eye is lost. The exact area of vision lost depends on where in the complex visual pathways the damage occurs.

HEMIPARESIS
A weakness of a limb (or limbs) so that useful function is lost or limited.

HEMIPLEGIA
A loss of movement in a limb (or limbs). If this is combined with spasticity, the affected limb is fixed and rigid.

HOME SUPPORT WORKER (HSW)
The concept of 'carers' for individuals who have had a brain injury is only appropriate sometimes - with the most disabled. Many persons who have had brain injury do not need care so much as prompting with some tasks, and a degree of assistance with others. Therefore enablers/home support workers (HSWs) are often more appropriate. The HSW has to have enough appreciation of the effects on the injured person to know what to do for them and what to prompt them to do.

HOMONYMOUS HEMIANOPIA
The most common form of hemianopia, in which the same (left or right) half of the visual field is lost in both eyes.

HYDROCEPHALUS
"Water on the brain". An excess of CEREBRO-SPINAL FLUID (qv) becomes trapped inside the ventricles of the brain, compressing brain tissue by pushing it outwards. This is potentially very damaging and may occur as a complication after head injury.

HYPOTHALAMUS
A gland in the mid part of the brain which is responsible for controlling many aspects of basic body functions.

HYSTERIA
A mental disorder which appears on the surface to be a physical symptom. For example, a seeming paralysis which is not based on physical impairment but is a manifestation of mental distress would be called an 'hysterical paralysis'. Obviously care needs to be taken to distinguish such a disorder from frank malingering and faking of symptoms.

IMPAIRMENT
A cognitive function, such as memory, is said to be impaired if the individual performs less well than would be expected in the light of estimated PREMORBID ABILITY (qv). Cognitive impairments may be subtle (a loss of sharpness) through to severe (a major handicap).

INATTENTION
See NEGLECT.

INFARCT
An area of dead or damaged tissue (eg brain tissue) resulting from loss of oxygen due to a vascular event, which causes blockage or arterial spasm.

INHIBITION
The 'damping down' of basic reactions, so that socially acceptable behaviour is maintained. Disinhibited patients may be prone to angry outbursts for little cause, boastfulness, swearing in inappropriate situations, unacceptable sexual advances, etc.

INTACT (and 'grossly intact')
Showing normal function. 'Grossly intact' means that on fairly cursory examination, no deficit was detected.

INTRACRANIAL HYPERTENSION
Increased pressure within the skull, often the result of swelling (oedema). An episode of high intracranial pressure can devastate the brain in a short period.

INTRACRANIAL PRESSURE (ICP)
The pressure within the skull. See INTRACRANIAL HYPERTENSION.

ISCHAEMIA
Diminished supply of blood. The brain's supply of blood may be diminished by other injuries (eg to the chest) or by impaired PERFUSION (qv).

JACKSONIAN FITS
Local spasm, affecting one side of the body or limb, due to irritation/damage to a particular area of the brain. (See also EPILEPSY).