Part 1Central nervous system and head injuries

Part 1—Central nervous system and head injuries Quadriplegia

•	Presence and extent of pain
•	Extent of any residual movement
•	Level of function and pre‑injury function
•	Ability to participate in daily activities, including employment
•	Presence and extent of secondary medical complications
•	Loss of reproductive or sexual function
•	Bowel or bladder incontinence

An ISV at or near the top of the range will be appropriate only if the injured person has assisted ventilation, extreme physical limitation and gross impairment of ability to communicate.

Paraplegia

•	Presence and extent of pain
•	Extent of any residual movement
•	Level of function and pre‑injury function
•	Ability to participate in daily activities, including employment
•	Loss of reproductive or sexual function
•	Bowel or bladder incontinence
•	Presence and extent of secondary medical complications 

Hemiplegia or severe paralysis of more than 1 limb

Examples of factors affecting ISV scale for item 3 The same examples apply as for item 2.

Additional comment for item 3 Incomplete paralyses causing whole person impairment of less than 40% must be assessed under orthopaedic injuries if it is the only injury or the dominant injury of multiple injuries.

3.1 Complete or nearly complete paralysis 3.2 Other paralysis, causing whole person impairment of at least 40% Monoplegia

See items 5, 6 and 7 and orthopaedic injuries section.

Extreme brain injury

The injury will involve major trauma to the brain with severe permanent impairment for which there is radiological evidence

•	An ISV at or near the top of the range will be appropriate only if the injured person needs full‑time nursing care and has the following—
•	gross disturbance of brain function
•	significant physical limitation and destruction of pre‑existing lifestyle
•	epileptic seizures
•	double incontinence
•	little or no language function
•	little or no meaningful response to environment
•	An injured person with an injury for which an ISV at or near the top of the range is appropriate may have some ability to follow basic commands, recovery of eye opening, return of postural reflex movement and return to pre‑existing sleep patterns.

Examples of factors affecting ISV assessment for item 5: • Extent of bodily impairment

Serious brain injury

The injured person will be very seriously disabled and substantially depends on others for professional and other care

Serious brain damage causing— (a) physical impairment, for example, limb paralysis; or (b) cognitive impairment with marked impairment of intellect and personality