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Definition of a brain injury: terms of reference

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Types of brain disorders

Definition of a brain injury: terms of reference

Over the years a brain injury has also been called a head injury, brain damage, acquired brain injury, neurocognitive disorder and a traumatic brain injury. 

There are also types of brain injury such as strokes, dementia and brain tumours that we might not automatically think of when we hear the term brain injury. 


It is important to not only define what a brain injury is, but also have a term that encompasses all the different types. Why is this important?


For too long various types of brain injury have been more  defined by their causes than the effects they produce and therefore the treatment and support needed. For example, a stroke, dementia and a brain tumour can lead to very similar effects but are regarded as very separate disorders.


This creates many problems, particularly when trying to raise awareness of what has often been called the invisible disability. This also ties in to the difficulty of obtaining funding and services when so many 'types' of brain injury are under different banners. 


Charities, disability services and community organizations are usually created and operated around a specific disability and this becomes part of their identity.  As time passes, there are changes in the research and evidence for various disabilities and organizations must evolve to not only survive, but best meet the needs of their clients. 


Neurocognitive Disorder - a better definition of brain injury?

The Diagnostic and Statistical Manual of Mental Disorders 5 (DSM5) has recently moved to the term 'Neurocognitive Disorder' which is very similar to the older term 'Acquired Brain Injury'. It still covers causes such as trauma, vascular disease, Alzheimer's disease and infection.


The term Neurocognitive Disorder, however, provides a diagnosis for people experiencing cognitive symptoms alone, without memory or physical impairments. This means that many individuals who are not currently receiving recognition or services (due to the lack of memory or physical impairments) will have this opportunity for understanding.


Brain Disorder - a more inclusive definition?

At Synapse, we are moving toward an even more inclusive definition by using the term 'Brain Disorder' - a disruption of normal brain functioning due to disease, trauma or genetics conditions.


What are some of the problems with the widely used term 'acquired brain injury'? First, the word 'injury' is concerned with harm done to the body which tends to preclude dementia, brain tumours and multiple sclerosis. 'Disorder' means the disruption of normal functioning so is a much more inclusive term. 


The word 'acquired' refers to a brain injury that has been sustained after birth, which precludes disorders such as Fetal Alcohol Syndrome which occur in the womb. In the USA, the term 'traumatic brain injury' is very common but this precludes many types of brain injury caused by lack of oxygen, a stroke, epilepsy, brain tumours and degenerative diseases. Its insistence that the brain injury must be caused by trauma is a needlessly exclusive criterion. 


The importance of a good definition

A definition must not only be accurate and evidence-based, but it must also have a purpose and be used responsibly towards an altruistic outcome. It is vital that organizations develop a planned and strategic approach to marketing, with an understanding of the key demographics. 


The reality is that a majority of the community sector has an issue with branding, with a lack of understanding around what a brand is, and how to communicate key messages.  With so many organizations struggling to be heard, there is a tendency to say as much as possible without a focus on what the core outcome is, or to what audience you are delivering the messages to.  


More often than not, a very simple message will be a conduit for engagement, and thus a much greater understanding.


With an issue as complex as Brain Disorders, it is much more effective to have an easily understood inclusive definition and message to promote. 


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