English for Stroke Nursing: Essential Vocabulary & Phrases

"FAST assessment"

A rapid screening tool for stroke recognition using four criteria: Facial drooping, Arm weakness, Speech difficulties, and Time to call emergency services

"The emergency nurse performed a FAST assessment at triage and confirmed facial droop and arm drift, activating the stroke team immediately."

"sudden onset neurological deficit"

The abrupt appearance of a focal brain symptom such as limb weakness, speech impairment, or vision loss, considered a stroke emergency until proven otherwise

"The patient reported sudden onset neurological deficit with right-sided weakness and slurred speech beginning forty minutes before arrival."

"last known well"

The precise time at which a patient was confirmed to be free of stroke symptoms, used to calculate treatment eligibility windows for thrombolysis and thrombectomy

"The paramedics documented last known well as 07:15 when the patient's family saw him speaking normally, making him eligible for intravenous alteplase."

"symptom onset"

The moment at which stroke symptoms first appeared, a critical time point that determines eligibility for acute reperfusion therapies

"Symptom onset was estimated at 02:00 when the patient woke with left-sided weakness, placing him outside the four-and-a-half-hour thrombolysis window."

"hemispheric stroke"

A stroke affecting one cerebral hemisphere, typically producing contralateral motor and sensory deficits on the opposite side of the body to the affected brain region

"The CT scan confirmed a right hemispheric stroke, consistent with the patient's left arm weakness, left facial droop, and left visual field loss."

"transient ischaemic attack"

A brief episode of neurological dysfunction caused by temporary focal brain ischaemia, resolving completely within 24 hours and often a warning sign of impending stroke

"The patient's fifteen-minute episode of speech difficulty and right arm weakness was diagnosed as a transient ischaemic attack requiring urgent investigation and secondary prevention."

"cortical signs"

Neurological features indicating cerebral cortex involvement in a stroke, including aphasia, neglect, gaze deviation, and visual field defects, helping to localise the lesion

"The nurse documented cortical signs including left-sided neglect and contralateral gaze deviation, suggesting a large right middle cerebral artery territory infarct."

"haemorrhagic transformation"

Bleeding into an area of ischaemic brain infarction, which can occur spontaneously or following reperfusion therapy and may worsen neurological outcome

"The follow-up CT at 24 hours showed haemorrhagic transformation of the infarct, and the neurology team adjusted the anticoagulation plan accordingly."

"NIHSS score"

A standardised 42-point neurological examination tool that quantifies stroke severity across eleven domains including level of consciousness, gaze, vision, facial palsy, limb strength, ataxia, sensation, language, dysarthria, and neglect

"The stroke nurse calculated an NIHSS score of 14 on admission, indicating a moderate-to-severe stroke, and repeated the assessment every four hours for the first 24 hours."

"level of consciousness"

A clinical assessment of a patient's arousal and responsiveness, graded from alert to comatose, forming the first domain of the NIHSS and a key indicator of stroke severity

"The level of consciousness was graded 2 on the NIHSS as the patient responded only to painful stimuli and was unable to follow simple verbal commands."

"gaze palsy"

Inability to voluntarily move both eyes in a particular direction due to disruption of the conjugate gaze pathways, seen in large hemisphere or brainstem strokes

"The nurse noted forced gaze deviation to the right and documented gaze palsy as a score of 2 on the NIHSS, suggesting a large left hemisphere lesion."

"facial droop"

Unilateral weakness of the facial muscles causing asymmetry of the face, including drooping of the corner of the mouth and flattening of the nasolabial fold, a cardinal sign of stroke

"A clear facial droop on the right side was identified during NIHSS assessment, with inability to fully raise the right corner of the mouth on command."

"pronator drift"

A sign of subtle upper limb weakness in which the outstretched arm slowly pronates and drifts downward when held horizontally with eyes closed, indicating contralateral motor pathway involvement

"The occupational therapist observed pronator drift of the left arm during NIHSS testing, suggesting mild residual corticospinal tract dysfunction on the right side."

"extinction and neglect"

The failure to attend to stimuli on one side of the body or space when simultaneous bilateral stimulation is applied, reflecting damage to the non-dominant parietal lobe

"The patient consistently failed to report touch on the left side when both hands were touched simultaneously, confirming extinction and neglect scored as 2 on the NIHSS."

"pupillary response"

The constriction of the pupils in response to light, assessed bilaterally to detect asymmetry or fixed dilation that may indicate raised intracranial pressure or brainstem involvement

"The nurse documented an absent pupillary response on the right side and reported the finding immediately as a sign of possible uncal herniation."

"Glasgow Coma Scale"

A 15-point neurological scale assessing eye opening, verbal response, and motor response to determine a patient's level of consciousness after brain injury or stroke

"On arrival, the patient's Glasgow Coma Scale was 9 (E2 V3 M4), indicating severe neurological impairment requiring urgent airway assessment and neurosurgical review."

"intravenous alteplase"

A recombinant tissue plasminogen activator given intravenously to dissolve a clot causing ischaemic stroke, licensed within 4.5 hours of confirmed symptom onset in eligible patients

"Intravenous alteplase was commenced at 0.9 mg/kg, with 10% given as a bolus over one minute and the remainder infused over 60 minutes, according to protocol."

"door-to-needle time"

The interval between a patient's arrival at hospital and the administration of intravenous thrombolysis, a key performance metric with a target of under 60 minutes

"The stroke coordinator recorded a door-to-needle time of 38 minutes, well within the national 60-minute benchmark, following rapid CT and thrombolysis decision-making."

"mechanical thrombectomy"

An endovascular procedure in which a stent retriever or aspiration catheter is used to physically remove a large vessel occlusion causing ischaemic stroke, indicated up to 24 hours in selected patients

"The interventional neuroradiologist performed mechanical thrombectomy and achieved complete recanalisation of the left middle cerebral artery after two retrieval passes."

"large vessel occlusion"

Blockage of a major intracranial artery such as the internal carotid artery, middle cerebral artery, or basilar artery, typically causing severe stroke and warranting thrombectomy assessment

"CT angiography confirmed a left middle cerebral artery large vessel occlusion and the patient was transferred urgently to the comprehensive stroke centre for thrombectomy."

"recanalisation"

The restoration of blood flow through a previously occluded artery, achieved by thrombolysis or mechanical thrombectomy, the primary goal of acute ischaemic stroke treatment

"Successful recanalisation was confirmed by post-procedure angiography, and the patient showed immediate neurological improvement with improved arm movement."

"thrombolysis contraindication"

A clinical or radiological finding that makes intravenous alteplase unsafe to administer, including recent surgery, severe hypertension, prior haemorrhage, or anticoagulant use

"The stroke nurse identified a thrombolysis contraindication as the patient had undergone abdominal surgery six days prior, and the team proceeded directly to thrombectomy planning."

"blood pressure management"

The controlled treatment or permissive elevation of blood pressure in acute stroke, guided by whether the patient has received thrombolysis and the type of stroke

"Post-thrombolysis blood pressure management targeted values below 180/105 mmHg, with labetalol titrated to keep the pressure within the safe range for 24 hours."

"penumbra"

The region of brain tissue surrounding a stroke core that is ischaemic but still viable, potentially salvageable by rapid reperfusion before irreversible infarction occurs

"Perfusion imaging demonstrated a large penumbra relative to the infarct core, indicating significant tissue at risk and supporting proceeding with late-window thrombectomy."

"dysphagia"

Difficulty or pain swallowing due to disruption of the swallowing reflex by stroke, placing patients at risk of aspiration pneumonia, malnutrition, and dehydration

"The nurse performed a water swallow test and identified dysphagia with coughing on thin fluids, referring the patient urgently to the speech and language therapist."

"aspiration pneumonia"

A lung infection caused by inhalation of food, liquid, or saliva into the airway, a leading cause of death in stroke patients with dysphagia and impaired cough reflex

"The patient developed a temperature of 38.6°C and a productive cough on day three; chest X-ray confirmed aspiration pneumonia and intravenous antibiotics were commenced."

"cerebral oedema"

Swelling of brain tissue following ischaemic infarction or haemorrhage, which can raise intracranial pressure, cause midline shift, and lead to clinical deterioration

"Repeat CT at 48 hours showed significant cerebral oedema with midline shift of 8 mm; the neurosurgical team was consulted regarding decompressive hemicraniectomy."

"post-stroke seizure"

An abnormal electrical discharge in the brain occurring as a direct consequence of stroke, either in the early phase within the first week or as late epilepsy after one month

"The patient experienced a focal post-stroke seizure with rhythmic jerking of the right arm on day two and was commenced on levetiracetam after neurology review."

"urinary incontinence"

The inability to control bladder emptying following stroke, caused by disruption of cortical inhibitory pathways, affecting up to half of all stroke patients in the acute phase

"Urinary incontinence was documented from admission and a prompted voiding programme was implemented to reduce catheter use and prevent urinary tract infection."

"deep vein thrombosis prophylaxis"

Preventive measures to reduce the risk of blood clots forming in the leg veins of immobile stroke patients, including compression stockings, hydration, and anticoagulant medications

"Deep vein thrombosis prophylaxis with intermittent pneumatic compression devices was initiated on admission as the patient was not eligible for anticoagulant therapy following haemorrhagic stroke."

"pressure injury prevention"

A systematic approach to protecting immobile or sensory-impaired stroke patients from skin breakdown, including regular repositioning, pressure-relieving mattresses, and skin assessment

"Hourly repositioning and a pressure-redistributing mattress were prescribed as part of the pressure injury prevention care plan for the hemiplegic patient with sensory loss."

"neurological deterioration"

A worsening of a patient's neurological status after initial presentation, indicated by a rising NIHSS score, decreasing level of consciousness, or new symptoms

"The nurse noted neurological deterioration with a drop in GCS from 13 to 9 and immediately alerted the medical team and arranged urgent repeat brain imaging."

"aphasia"

An acquired language disorder caused by damage to the language-dominant hemisphere, affecting the ability to speak, understand speech, read, and write in varying combinations

"The stroke nurse documented expressive aphasia with largely preserved comprehension, and positioned a communication board at the bedside to support the patient's interaction with staff."

"expressive aphasia"

Also called Broca's aphasia; a type of aphasia in which the patient understands language but has marked difficulty producing fluent, meaningful speech, often speaking in short phrases or single words

"Despite good comprehension, the patient with expressive aphasia could only produce single words and showed great frustration during attempted communication, requiring extra time and patience from nurses."

"receptive aphasia"

Also called Wernicke's aphasia; a type of aphasia characterised by fluent but meaningless speech and severely impaired comprehension of spoken and written language

"The speech and language therapist diagnosed receptive aphasia as the patient produced fluent but incoherent speech and was unable to follow simple two-step verbal commands."

"dysarthria"

A motor speech disorder caused by weakness or incoordination of the muscles used in speech production, resulting in slurred, slow, or unclear articulation without affecting language comprehension or formulation

"The patient's dysarthria made his speech difficult to understand, but his comprehension was fully intact and he communicated effectively using writing and gesture."

"augmentative and alternative communication"

A range of strategies and devices beyond speech used to support communication in patients with aphasia or dysarthria, including picture boards, letter charts, and electronic speech-generating devices

"The speech therapist introduced augmentative and alternative communication tools including a symbol-based communication app on a tablet, enabling the patient to express basic needs independently."

"supported conversation"

A structured approach to communicating with a person who has aphasia, using techniques such as writing key words, using gesture, drawing, and confirming understanding to ensure a two-way exchange

"Staff were trained in supported conversation techniques, including writing key words and checking understanding, to improve the quality of interaction with aphasic patients on the stroke unit."

"communication board"

A low-technology tool containing pictures, symbols, or words that a patient with aphasia or dysarthria can point to in order to express basic needs, feelings, and information

"A personalised communication board with images of common needs, family members, and yes/no symbols was laminated and placed at the head of the bed for immediate use."

"speech and language therapy referral"

The formal request for assessment and intervention from a speech and language therapist for a stroke patient presenting with dysphagia, aphasia, or dysarthria

"A speech and language therapy referral was submitted within four hours of admission in line with the stroke unit protocol for all patients with communication or swallowing difficulties."

"early mobilisation"

The initiation of sitting, standing, and walking exercises within the first 24 to 48 hours of stroke onset to reduce complications, improve recovery, and shorten hospital stay

"The physiotherapist initiated early mobilisation on day one, assisting the patient to sit at the edge of the bed and stand with support despite mild left-sided weakness."

"hemiplegia"

Complete paralysis affecting one side of the body caused by damage to the corticospinal tract in the contralateral hemisphere, a common consequence of large territory stroke

"The patient's hemiplegia required two-nurse hoisting for all transfers and a pressure-redistributing mattress to prevent skin breakdown on the affected side."

"hemiparesis"

Partial weakness on one side of the body, less severe than hemiplegia, that allows some voluntary movement but impairs strength and coordination in the affected limbs

"With ongoing physiotherapy, the patient's hemiparesis improved significantly over three weeks, progressing from requiring a walking frame to mobilising independently with a stick."

"modified Rankin Scale"

A six-point scale measuring the degree of disability and dependence in patients after stroke, ranging from 0 (no symptoms) to 6 (death), used to measure functional outcome

"At three-month follow-up, the patient's modified Rankin Scale score had improved from 4 to 2, indicating independent function with only minor restrictions in daily activity."

"secondary prevention"

Pharmacological and lifestyle measures taken after a first stroke or TIA to reduce the risk of a subsequent stroke, including antiplatelet agents, statins, antihypertensives, and anticoagulation for atrial fibrillation

"The secondary prevention plan prescribed dual antiplatelet therapy for 21 days followed by lifelong aspirin, a high-intensity statin, and antihypertensive optimisation."

"carotid endarterectomy"

A surgical procedure to remove atherosclerotic plaque from the internal carotid artery in patients with significant ipsilateral carotid stenosis following a TIA or non-disabling stroke

"The vascular surgeon performed carotid endarterectomy within seven days of the TIA in the symptomatic patient with 80% ipsilateral carotid stenosis to reduce stroke recurrence risk."

"anticoagulation"

The use of blood-thinning medications such as warfarin or direct oral anticoagulants to prevent cardioembolic stroke in patients with atrial fibrillation or other thromboembolic conditions

"Anticoagulation with apixaban was commenced two weeks after the ischaemic stroke in the patient with newly diagnosed atrial fibrillation following neurology review."

"multidisciplinary team meeting"

A regular structured meeting of the stroke nursing, medical, physiotherapy, occupational therapy, speech therapy, social work, and dietetics teams to review each patient's progress and plan discharge

"At the weekly multidisciplinary team meeting, the goal for the coming week was set as independent transfers and stairs practice in preparation for discharge to the patient's own home."