Traumatic Brain Injury (TBI) Definitions

Close Up Of Old English Dictionary Page With Word Brain.

  • AAOX [1, 2 or 3]:   Acronym for Awake, Alert, and Oriented Times 1 (person), Times 2 (person and place) and Times 3 (person, place, and time). It is a clinical shorthand for the findings in a physical examination of a patient, referring to a patient who is responsive to his/her environment, knows who he/she is, where he/she is and the approximate time.
  • Altered Mental Status (AMS):   A disruption in how the brain works resulting in changes in behavior. AMS ranges from confusion, total disorientation, increased sleepiness, and coma.
  • Biological Marker (Biomarker):   Measurable substance in an organism whose presence indicates some biological state or condition, like a disease, infection, injury or environmental exposure.
  • Computerized Axial Tomography (CAT) Scan:  An imaging method that uses X-rays to create pictures of cross-sections of the body.
  • Concussion:   The American Association of Neurological Surgeons defines concussion as an injury to the brain that results in temporary loss of normal brain function.1 “The formal medical definition of concussion is a clinical syndrome characterized by immediate and transient alteration in brain function, including alteration of mental status and level of consciousness, resulting from mechanical force or trauma.”
  • Contusion:   A bruise (bleeding) on the brain.
  • Coup and countrecoup injury:   In head injury, a coupe occurs on the site of impact. A countrecouup occurs on the side opposite of the area of impact. For example, when the brain accelerates forward, hits the side of the skull, and then bounces off the other side of the skull.
  • Diffuse Axonal Injury (DAI):  It falls under the category of a diffuse brain injury. This means that instead of occurring in a specific area, like a focal brain injury, it occurs over a more widespread area. DAI is one of the most common and devastating types of traumatic brain injury, and is a major cause of unconsciousness and persistent vegetative state after head trauma.
  • Diffusion Tensor Imaging (DTI):  Is a MRI-based neuroimaging which allows to visualize the location, orientation, and composition of the brain’s white matter tracts. According to some studies, this method may be a reliable way to diagnose and monitor mild traumatic brain injury.
  • Electroencephalogram (EEG):  Is a neurological test that uses an electronic monitoring device to measure and record the electrical activity in the brain.
  • Focal Brain Injury:  Is an injury that is confined to one area of the brain. In most cases, the brain tissue is damaged at the site where the injury occurred. A Focal Brain Injury can be closed when there is no penetration of the skull, or open when an object pierces the skull and enters brain tissue.
  • Glasgow Coma Scale (GCS):  A neurological scale which aims to give a reliable and objective way of recording the conscious state of a person for initial and subsequent assessment. It is the summation of scores for eye, verbal and motor responses. The scale ranges from a minimum of 3, which indicates deep coma or brain-dead state, to the maximum of 15, which indicates a fully awake patient. The original maximum was 14, but the score has been modified since then.
  • Head Injury:  By definition, an injury to the skull. Should not be confused with brain injury which by definition is an injury to the brain and which may result from a head injury.
  • Hematoma:   A mass of clotted blood that forms in a tissue, organ, or body space as a result of a broken blood vessel.
  • Loss of Consciousness (LOC):  A partial or complete interruption of awareness of oneself and one’s surroundings.
  • Magnetic Resonance Angiography (MRA):  A series of techniques which are based on MRI to visualize and image blood vessels.
  • Magnetic Resonance Imaging (MRI) Scan:   An imaging test that uses magnets and radio waves to create pictures of the body and/or its organs. It does not use radiation.
  • Magnetic Resonance Spectroscopy:   Also known as nuclear magnetic resonance (NMR) spectroscopy, which is a non-invasive, ionizing radiation free analytical technique that has been used to study metabolic changes in brain tumors, strokes, seizure disorders, Alzheimer’s disease, depression, and other diseases affecting the brain.
  • Mild traumatic brain injury (mTBI)2:   A patient with a mild traumatic brain injury has had a traumatically induced physiological disruption of brain function. An MTBI manifests with at least one of the following:
    1. Any period of loss of consciousness;
    2. Any loss of memory for events immediately before or after the accident;
    3. Any alteration in mental state at the time of the accident (eg., feeling dazed, disoriented, or confused); and/or
    4. Focal neurological deficit(s) that may or may not be transient;

    But the severity of the injury does not exceed the following:

    1. Loss of consciousness of approximately 30 minutes or less;
    2. After 30 minutes, an initial Glasgow Coma Scale (GCS) of 13-15; and
    3. Posttraumatic Amnesia (PTA) not greater than 24 hours.

    It is worth mentioning that this definition differs from other conventional mTBI definitions in that the cause of the MTBI is not limited to head blows. This definition also suggests that the brain can be injured as a result of an acceleration/deceleration movement without direct external trauma to the head (i.e. whiplash, shaken baby syndrome).

  • Miserable Minority:   The majority of people who sustain a Mild Traumatic Brain Injury (75-85%) will have their symptoms resolved within 3 to 6 months. However, there is substantial documentation of a “Miserable Minority” (coined by Ron Ruff, neuropsychologist) who will face life-altering changes after suffering a concussion or an MTBI.
  • Moderate Traumatic Brain Injury:  Occurs when the injury results in a loss of consciousness of 30 minutes to 24 hours and an initial Glasgow Scale of 9-12. Post-traumatic amnesia can last 24 hours to seven days.
  • Positron Emission Tomography (PET):  Is a test that uses small amounts of radioactive materials called radiotracers, a special camera and a computer to help evaluate a certain organ and tissues.
  • Post-concussion syndrome (PCS):  A set of symptoms (headache, dizziness, fatigue, etc.) that take place after a brain injury that may continue for weeks, months, or even years. Symptoms that last longer than 6 months are called persistent post-concussion syndrome (PPSC).
  • Post-traumatic Amnesia (PTA):  A state of confusion or memory loss that occurs immediately following a traumatic brain injury. As a result, the injured person is unable to remember events that occur after the injury and may be unable to state their name, where they are, or other basic details. The amnesia can be categorized as retrograde or anterograde. Retrograde amnesia refers to a loss of memories that were formed shortly before the injury. Anterograde amnesia takes place when there are problems creating new memories after the injury.
  • Second impact syndrome:   Is a rare condition in which a second concussion occurs before the first concussion has properly healed, causing rapid and severe brain swelling, which can lead to catastrophic consequences, such as death.
  • Severe Traumatic Brain Injury:   Occurs when the injury results in loss of consciousness of greater than 24 hours, an initial Glasgow Coma Scale of 3-8, and post-traumatic amnesia period of greater than seven days.
  • Signs:  Also referred to as “Objective Findings”. These are verifiable indications of injury or disease. In other words, something that anyone other than the patient, can see. Examples: Imaging, MRI, blood test results, GCS, etc.
  • Single Photon Emission Computed Tomography (SPECT):  Is a type of nuclear imaging test that shows how blood flows to tissues and organs.
  • Subdural Hematoma:  Occurs when blood collects on the brain’s surface beneath the skull and can be life-threatening. A subdural hematoma usually results from a head injury. Subdural hematomas are either acute or chronic, depending on the severity of the head injury.
  • Symptoms:  Also referred to as “Subjective Complaints”. A sensation which is perceptible only by the patient. In other words, it is what the patient complains about, what he feels, senses, etc. Examples: headaches, dizziness, etc.
  • Traumatic Brain Injury (TBI):   According to the Brain Injury Association of America, a TBI is defined as an alternation in brain function or other evidence of brain pathology caused by an external force. The external force can consist of a blow to the head or from a rapid acceleration-deceleration event. It is possible for the brain to become injured even if the head was not directly struck. The brain can become injured whether or not the skull is fractured. Traumatic Brain Injury can be classified as Mild, Moderate, and Severe.
1 http://www.aans.org/patient%20information/conditions%20and%20treatments/concussion.aspx
2 Developed by the Mild Traumatic Brain Injury Committee of the Head Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitation Medicine.

what our clients are saying

“ Great lawyer
James worked so hard for me..great guy listen when I had questions about my case....Very honest I trust him with my life....He did what he said he would do for me and won a big case.....Thank you James........ ”
Eve
“ Thank you to the Amaro Law Firm. Professional and courteous the whole way through. I recommend anyone who is need of legal assistance to contact Amaro Law Firm. Kept in such good communication with me as well as follow ups. Truly a great team! ” Nicholas Carter
Best Lawyer in H-Town! Mr Amaro is the lawyer to have on your side when it comes to understanding your client's needs. He fought to give us the best result, highly recommended. ” Sam Barroso
“ I highly recommend the Amaro Law Firm. The attorneys and staff are attentive, professional and GREAT at what they do. It was been a pleasure to work with them, and they get GREAT results! Give them a call, you won't be disappointed!! ” Jennifer Sindelar Shanahan
I have had the pleasure of working with Mr. Amaro and his team for over 5 years. He and his staff are always so pleasant and professional. ”
Amber Epperson
Fredo Rodriguez
Billy Hext
Maricela Vazquez
The professionals at The Amaro Law Firm are talented, responsive and always fight for the best results for their clients. I have worked together with this firm over the past several years, and always have had a positive experience. ”
Alan Quiles
After choosing the Amaro Law Firm it was evident that I had made the right decision in hiring them! They have been wonderful to work with. Always keeping me up to date with the progress of my claim and answering any questions that I may have. I would definitely recommend the Amaro Law Firm for anyone that wants a company that will stand up for them and work hard for what is theirs. ”
Katherine Sirmon
I highly recommend Amaro Law Firm! The entire team at the firm are knowledgeable and courteous, and most importantly, get the job done! These guys are not afraid of trial cases, and will fight until the end. Thanks guys! You're the best! ”
Kenneth Akiri
I was very fortunate to be able to work with David Miller of the Amaro Law Firm. They went above and beyond what other attorneys were willing to do to get the maximum recovery they could for their clients. I would highly recommend them to anyone for any type of case. ”
Venetia Varden
My case was a sucess My attorney Mr. James Amaro was spectacular during my entire case. His staff and office were always very helpful and always made sure to answer all my questions during my legal process. I am very happy with the settlement of my case and how aggressive he was against the insurance companies who were not willing to settle before mediation. ” Don
“ The Amaro Law Firm was very thorough and fast in resolving my claim, I would recommend their service. ” L. D.
Amaro Law Firm has great customer service. They are very professional and alway a pleasure to work with. Mr. Amaro has a great team especially Wendy. They are very dedicated employees. ”
Regena Ratcliff
“ James is a great resource for me when it comes to case analysis, trial strategy, and responding to legal issues. He is a great person to help think of different way to present cases or to handle complex issues. ” A Private Practice Attorney
“ Great experience! James was very knowledgeable, responsive and was always accessible to answer my questions and concerns. I will definitely work with his firm again. Thank you! ” Scott
Hard worker who goes the extra mile for his clients! I have worked with James for many years now and I am always blown away about his dedication to his firm. He truly cares about his staff and clients. Great guy and a very knowledgeable attorney. ” Kris Cox
I have performed work for the Amaro Law Firm in support of their recent move to their new location. Such a pleasant staff! All friendly & so very helpful! Great attitudes! A wonderful group of folks to work with and for! ”
Herb Zieschang
Amaro law firm did an outstanding job getting me the most money for my insurance claim. They always kept me well informed and provided me with a great case manager!! ”
Alberto Flores
Satisfied client, I was very pleased on how fast he settled my case and the amount. I will refer my friends and family, thank you Amaro Law Firm . ” Rosie Navarrette
Satisfied client I chose Amaro Law Firm after an insurance company tried to take advantage of me. As soon as I spoke to one of the representatives I automatically felt comfortable and confident that I was going to be taken care of. They communicated all plans and any changes during the process and most of all they were always honest. I was extremely happy with the settlement and would recommend them to anyone who wants results. Thank you Amaro Law Firm for the great customer service and for taking action! ” A client
Excellent knowledgeable attorneys with helpful and patient staff. Zealous advocates for their clients' rights and interests. You want these guys on your side. ”
Kristen Osborne
“ The Amaro Law Firm is not afraid to pick a fight with money hungry insurance companies. In my case, they were extremely professional and achieved results that I thought were totally out of reach. I highly recommend this firm. ” R. L.
They care greatly about the experience their clients have, when calling their business. Clients are treated with the utmost respect by the Amaro Law Firm. They take the time to really address their concerns and problems, effective and accurately. ”
Kelly Cammack
This is a great firm that I highly recommend. They are very responsive, attentive, and aggressive in their representation of you. The attorneys and staff will fight hard for you! ”
Jennifer Shanahan
Great to do business with them, good service! ”
Abid Sattani
I have known the Amaro firm for many years, and have had many great experiences with them. I have referred clients to them that have also had great experiences, and rave about how hard the Amaro firm worked for them. The Amaro firm is my number one firm to go to for anything including personal injury claims, business disputes, insurance claims, hurricane claims, and commercial litigation. ”
Travis Funkhouser
Joe T Olvera
The Amaro Law Firm Peer Review James Amaro is a very knowledgable and thorough lawyer. He puts his clients' interests first. He will help you in your time of need. ” Jeff Greco
“ We have had the pleasure of working with the Amaro Law Firm recently.... I have found the Mr. Amaro and the entire Amaro Law Firm staff to be friendly, knowledgeable, fair and always available to speak with us when we need them.... I would highly recommend the Amaro Law Firm to my friends, colleagues and family! Thanks for being there for us Amaro Law Firm! It's nice to have people we can trust and depend on!!! Brett M. Downey, D.C. Fairview Health Center ” Fairview Health Center