The term higher brain dysfunction 　What image do you have when you hear the term "higher brain dysfunction"? 　As a physician, I often use this term when writing medical certificates. 　This is because in 2006, the Ministry of Health, Labor and Welfare announced the diagnostic criteria for higher brain dysfunction, and if a diagnosis is made based on these criteria, the diagnosis can be used in the Mental Disability Health and Welfare Handbook and Medical Care for Services and Supports for Persons with Disabilities. It is now possible to receive treatment and rehabilitation with health insurance. I am really grateful for this. Besides, it somehow sounds good. The word "higher order" has a somewhat high-class feel to it. 　However, there are a few things to note about this term as well. This is only an administrative diagnosis, defined by the Ministry of Health, Labor and Welfare. Strictly speaking, if we take the term "higher brain function" to mean the function of the higher brain in humans, then higher brain dysfunction can be caused by intellectual disability, mental disorder, or dementia. However, as defined by the Ministry of Health, Labor and Welfare, the term "higher brain dysfunction" in Japan refers mainly to cognitive impairment caused by brain damage. 　The term "brain damage" has been used. This means that the brain is injured for some reason during the course of life. Therefore, in the United States, the United Kingdom, and Australia, the term "brain injury" is used instead of "higher brain dysfunction. In English, it is called brain injury. 　As I mentioned earlier, this is a diagnosis defined administratively by the Ministry of Health, Labor and Welfare, so it is neither a new disease that has suddenly emerged nor a rare disease. 　When the brain is damaged, physical, cognitive (neuropsychological) and psychiatric symptoms occur. Of these, symptoms such as memory, attention, and executive function, in particular, have not been considered "disorders" by themselves until now. It is indeed a difficult disorder to see. Until now, a brain injury, such as immobility, severely impaired intelligence, or hallucinations and delusions, have been recognized as illnesses or disabilities, but now light has been shed on even more difficult-to-see areas. 　He said, "I was in a motorcycle accident, took six months off, and now I'm ready to go back to work. The doctor says I have higher brain dysfunction, but how do I explain it? I am told that I have higher brain dysfunction, don't you know? Should I say, "Well, I'll have a specialist explain it to you"? 　I suggest that rather than giving the client a vague and difficult diagnosis of higher brain dysfunction, the client should be told the cause and, if necessary, the main symptoms that he or she wants people to understand. For example, "I had a motorcycle accident, hit my head, was unconscious for three weeks and recovered, but I seem to have lost some memory. But I've learned in rehab how to keep notes and use my cell phone so I don't forget, so I think I'll be fine." How about this? 　"I have higher brain dysfunction. You don't know about it? You don't know enough about it?" or "Here is a pamphlet I got at the hospital. Please read this pamphlet from the hospital and study it. This is because pamphlets and information on the Internet are full of symptoms of higher brain dysfunction, some of which do not apply to you, and may omit your important symptoms. It is a good idea to go to the office prepared to say, "I am going to mention these two symptoms as my symptoms. 　I think it is correct to use this name where it is convenient and to be creative where it is inconvenient.