神経科看護英語：必須語彙とフレーズ

"Glasgow Coma Scale"

A standardised scoring system that assesses level of consciousness by rating eye opening, verbal response, and motor response, with a total score ranging from 3 to 15

"The neurology nurse documented a Glasgow Coma Scale score of 10 (E3V3M4) and alerted the registrar to the deterioration from an earlier score of 14."

"pupillary response"

The constriction of the pupil when a light is shone into the eye, assessed for size, equality, and reactivity as an indicator of brainstem and third cranial nerve function

"The nurse noted an absent pupillary response on the right side and immediately called the neurosurgery team, suspecting transtentorial herniation."

"level of consciousness"

A clinical measure of a patient's wakefulness and awareness, ranging from full alertness through confusion, drowsiness, and stupor to coma

"Hourly neurological observations revealed a declining level of consciousness over four hours, prompting an urgent CT head."

"AVPU scale"

A rapid assessment tool that classifies a patient's responsiveness as Alert, responding to Voice, responding to Pain, or Unresponsive

"On arrival to the emergency department the patient scored P on the AVPU scale, responding only to a sternal rub, and was transferred immediately to resuscitation."

"focal neurological deficit"

A localised impairment of neurological function such as limb weakness, facial droop, or speech difficulty, pointing to damage in a specific region of the brain or spinal cord

"The FAST assessment identified facial asymmetry and left arm drift as focal neurological deficits, and the stroke pathway was activated within three minutes."

"pronator drift"

A subtle sign of upper motor neuron weakness in which an outstretched arm with the palm facing upward slowly rotates inward and drifts downward when the eyes are closed

"The nurse asked the patient to hold both arms out with palms up and eyes closed; the left arm showed pronator drift, indicating contralateral hemisphere pathology."

"neurological observation chart"

A structured documentation tool used in neuroscience nursing to record sequential GCS scores, pupil reactions, limb movements, vital signs, and blood glucose at regular intervals

"The neurosurgical ward used a standardised neurological observation chart with one-hourly recordings for all patients in the first 24 hours after craniotomy."

"cranial nerve examination"

A systematic bedside assessment of the twelve cranial nerves, evaluating functions including vision, eye movements, facial sensation, hearing, swallowing, and tongue movement

"A cranial nerve examination revealed reduced corneal reflex and diminished gag reflex in the patient admitted with a posterior fossa tumour."

"intracranial pressure"

The pressure within the skull exerted by the brain tissue, cerebrospinal fluid, and cerebral blood; normal is below 15 mmHg; sustained values above 20 mmHg indicate raised ICP requiring treatment

"The ICP monitor displayed a sustained intracranial pressure of 28 mmHg, and the nurse positioned the patient at 30 degrees head-up and informed the neurosurgeon."

"Cushing's triad"

A late and ominous sign of critically raised intracranial pressure comprising hypertension, bradycardia, and irregular breathing, indicating imminent brainstem herniation

"The bedside nurse recognised Cushing's triad when the patient's blood pressure rose to 200/110 mmHg alongside a heart rate of 42 and Cheyne-Stokes respirations, triggering an emergency response."

"cerebral perfusion pressure"

The net pressure driving blood flow to the brain, calculated as mean arterial pressure minus intracranial pressure; a minimum of 60–70 mmHg is needed to maintain adequate cerebral oxygenation

"With the ICP at 22 mmHg and MAP at 75 mmHg, cerebral perfusion pressure was only 53 mmHg, prompting vasopressor initiation to protect brain oxygenation."

"cerebral oedema"

Abnormal accumulation of fluid within the brain parenchyma that increases brain volume, raises intracranial pressure, and can displace brain structures if severe

"Post-operative MRI confirmed perilesional cerebral oedema, and the patient was commenced on dexamethasone to reduce vasogenic swelling around the tumour resection site."

"ventriculostomy"

The surgical insertion of a catheter into a cerebral ventricle to measure intracranial pressure directly and drain cerebrospinal fluid as a treatment for raised ICP

"The neurosurgeon performed a bedside ventriculostomy, allowing the nurse to both monitor ICP continuously and drain CSF in controlled aliquots when pressure exceeded 20 mmHg."

"herniation"

The displacement of brain tissue through natural openings in the skull or tentorium due to a pressure gradient, a life-threatening emergency that compresses the brainstem

"Bilateral fixed dilated pupils and absent motor response indicated uncal herniation, and immediate osmotherapy with mannitol was administered while the theatre team was alerted."

"osmotherapy"

The intravenous administration of hyperosmolar agents such as mannitol or hypertonic saline to draw fluid out of brain tissue and rapidly reduce intracranial pressure

"Osmotherapy with 20% mannitol 1 g/kg was infused over 20 minutes as a bridge to emergency neurosurgical decompression in the patient with a traumatic subdural haematoma."

"secondary brain injury"

Neurological damage that occurs after the initial insult as a result of ischaemia, hypoxia, hypotension, hypoglycaemia, seizures, or raised ICP, all of which nursing interventions aim to prevent

"The neurocritical care team implemented a bundle to prevent secondary brain injury, including strict normoglycaemia, avoidance of hypotension, and continuous seizure monitoring."

"ischaemic stroke"

Sudden neurological deficit caused by occlusion of a cerebral artery that interrupts blood flow to a region of the brain, accounting for approximately 85% of all strokes

"CT perfusion imaging confirmed a left middle cerebral artery ischaemic stroke, and the patient met criteria for intravenous thrombolysis within the 4.5-hour time window."

"haemorrhagic stroke"

A stroke caused by rupture of a blood vessel within or around the brain, including intracerebral haemorrhage and subarachnoid haemorrhage, often associated with sudden severe headache and rapid deterioration

"The patient presented with a thunderclap headache and neck stiffness; CT confirmed a haemorrhagic stroke due to subarachnoid haemorrhage from a ruptured anterior communicating artery aneurysm."

"thrombolysis"

The intravenous administration of alteplase (tPA) to dissolve a clot causing ischaemic stroke, given within 4.5 hours of symptom onset after ruling out haemorrhage

"The stroke nurse coordinated door-to-needle thrombolysis in 38 minutes, ensuring the patient received alteplase within the recommended time window."

"mechanical thrombectomy"

A minimally invasive neuroradiological procedure to physically retrieve a clot from a large cerebral artery using a stent retriever or aspiration catheter, extending the treatment window to 24 hours in selected patients

"The patient was transferred directly to the interventional suite for mechanical thrombectomy after CT angiography demonstrated occlusion of the right internal carotid artery terminus."

"NIHSS score"

National Institutes of Health Stroke Scale; a validated 42-point tool that quantifies stroke severity by scoring consciousness, vision, motor function, sensation, language, and neglect

"An NIHSS score of 16 on admission indicated a severe stroke, and the team initiated the major stroke pathway including neurosurgical co-management."

"dysphagia screen"

A bedside assessment to identify impaired swallowing function in stroke patients before any oral intake, typically using a standardised water swallow test to prevent aspiration pneumonia

"All patients admitted to the stroke unit underwent a dysphagia screen within four hours of arrival; those who failed were kept nil by mouth and referred to speech and language therapy."

"atrial fibrillation in stroke"

Cardiac arrhythmia responsible for approximately one in three cardioembolic strokes; detection guides anticoagulation decisions to prevent recurrence

"Continuous cardiac monitoring revealed paroxysmal atrial fibrillation in stroke during the 72-hour monitoring period, and the neurologist prescribed direct oral anticoagulation after the haemorrhage exclusion period."

"penumbra"

The zone of brain tissue surrounding the core infarct that is ischaemic but still metabolically viable; the target of reperfusion therapies aiming to restore function before tissue death

"Perfusion imaging demonstrated a substantial penumbra surrounding the infarct core, supporting the decision to proceed with thrombectomy despite a 10-hour onset-to-arrival time."

"tonic-clonic seizure"

A generalised seizure with two phases: a tonic phase of sustained muscle rigidity and apnoea, followed by a clonic phase of rhythmic jerking movements, after which the patient is typically confused and fatigued

"A witness described a tonic-clonic seizure lasting 90 seconds with a five-minute post-ictal period of drowsiness before the patient regained orientation."

"status epilepticus"

A medical emergency defined as a seizure lasting more than five minutes, or two or more seizures without recovery of consciousness between them, requiring urgent benzodiazepine treatment

"The nurse administered buccal midazolam when the seizure exceeded five minutes and called the resuscitation team, as the patient met criteria for status epilepticus."

"post-ictal state"

The period of altered consciousness, confusion, fatigue, headache, or focal weakness that typically follows a seizure as the brain recovers from the episode

"During the post-ictal state the patient was placed in the recovery position, oxygen was applied, and neurological observations were recorded every 15 minutes until full orientation returned."

"aura"

A subjective warning symptom preceding a seizure, such as an unusual smell, visual disturbance, rising epigastric sensation, or déjà vu, reflecting focal onset of electrical activity

"The patient reliably experienced a metallic taste aura lasting 10–15 seconds before each complex partial seizure, allowing time to sit safely before the onset of automatisms."

"anti-epileptic drug"

Medication prescribed to reduce the frequency and severity of seizures by stabilising neuronal membranes or modulating neurotransmitter activity; examples include levetiracetam, sodium valproate, and lamotrigine

"The nurse counselled the patient on the importance of not abruptly discontinuing their anti-epileptic drug, explaining that sudden cessation could precipitate rebound seizures."

"seizure threshold"

The level of neurological stimulus required to trigger a seizure, influenced by sleep deprivation, illness, alcohol, missed medication, and electrolyte imbalance

"The team identified that hyponatraemia had lowered the seizure threshold, and sodium correction was prioritised alongside anti-epileptic drug optimisation."

"focal onset seizure"

A seizure that begins in a specific region of one cerebral hemisphere, which may or may not spread to involve the whole brain; previously called partial seizure

"The EEG confirmed right temporal focal onset seizure activity consistent with the patient's reported episodes of lip smacking and unresponsiveness lasting 60–90 seconds."

"benzodiazepine rescue medication"

Fast-acting benzodiazepine drugs such as buccal midazolam or rectal diazepam prescribed for use by carers or nurses to terminate prolonged or cluster seizures outside hospital

"The epilepsy specialist nurse trained the patient's family to administer benzodiazepine rescue medication at home if any seizure exceeded five minutes."

"multiple sclerosis relapse"

An episode of new or worsening neurological symptoms in a patient with MS lasting more than 24 hours, caused by an inflammatory demyelinating lesion; treated with high-dose steroids

"The MS specialist nurse assessed the patient presenting with a multiple sclerosis relapse involving optic neuritis and arranged a three-day course of intravenous methylprednisolone 1 g."

"Parkinson's medication timing"

The critical importance of administering levodopa and other Parkinson's drugs at the exact prescribed times to prevent off periods, rigidity, and swallowing difficulties in hospitalised patients

"The ward nurse escalated the concern that Parkinson's medication timing had been disrupted by the nil-by-mouth order and arranged for enteral levodopa to be administered via nasogastric tube."

"spasticity"

A velocity-dependent increase in muscle tone due to upper motor neuron damage, causing stiffness, spasms, and pain in patients with MS, stroke, or spinal cord injury

"The physiotherapist and neurology nurse developed a positioning and stretching programme to manage the patient's lower limb spasticity and prevent contractures during the rehabilitation phase."

"autonomic dysreflexia"

A potentially life-threatening hypertensive emergency in patients with spinal cord injury at or above T6, triggered by a noxious stimulus below the level of injury such as a blocked catheter or pressure sore

"The nurse recognised autonomic dysreflexia when the tetraplegic patient's blood pressure rose to 185/110 mmHg with sweating and headache; a blocked catheter was identified and relieved within two minutes."

"disease-modifying therapy"

A class of medications used in multiple sclerosis that reduce the frequency and severity of relapses and slow disability progression by modulating the immune response

"The MS nurse coordinated the initiation of a high-efficacy disease-modifying therapy and provided comprehensive education on injection technique, monitoring requirements, and side-effect management."

"motor neurone disease"

A progressive and fatal neurological condition causing degeneration of upper and lower motor neurones, leading to muscle weakness, wasting, fasciculations, and eventual respiratory failure

"The palliative care and neurology team worked together to manage the patient's motor neurone disease, focusing on symptom control, communication aids, and advance care planning regarding ventilatory support."

"neurogenic bladder"

Bladder dysfunction resulting from neurological damage to the spinal cord or brain, causing impaired storage, incomplete emptying, or incontinence requiring catheterisation or bladder training

"The continence nurse specialist assessed the neurogenic bladder in the patient with MS and established an intermittent self-catheterisation programme to reduce infection risk and improve quality of life."

"fatigue in neurological disease"

An overwhelming and disproportionate sense of tiredness that is one of the most common and disabling symptoms of MS, Parkinson's disease, and post-stroke syndrome, distinct from normal tiredness

"The occupational therapist helped the patient manage fatigue in neurological disease by teaching energy conservation techniques and restructuring daily activities to align with periods of higher energy."

"lumbar puncture"

A procedure in which a needle is inserted into the lumbar subarachnoid space to obtain cerebrospinal fluid for analysis or to measure CSF opening pressure

"The nurse prepared the trolley for lumbar puncture, positioned the patient in the left lateral decubitus position with knees drawn to chest, and monitored for post-procedural headache over the following four hours."

"cerebrospinal fluid analysis"

Laboratory examination of CSF obtained by lumbar puncture, assessing colour, cell count, protein, glucose, culture, and cytology to diagnose meningitis, encephalitis, subarachnoid haemorrhage, and demyelinating disease

"Cerebrospinal fluid analysis showed xanthochromia and elevated red cells consistent with subarachnoid haemorrhage, despite a normal initial CT head."

"craniotomy"

A neurosurgical procedure in which a section of skull is temporarily removed to allow access to the brain for tumour resection, haematoma evacuation, or aneurysm clipping

"Post-craniotomy nursing care included hourly neurological observations, wound care, head-of-bed elevation to 30 degrees, and monitoring for signs of raised intracranial pressure."

"deep brain stimulation"

A neurosurgical treatment in which electrodes are implanted into specific brain targets and connected to a pulse generator to modulate abnormal neural circuits in Parkinson's disease and dystonia

"The specialist nurse programmed the deep brain stimulation device in clinic, titrating stimulation parameters to optimise motor function while minimising side effects such as dysarthria and diplopia."

"EEG monitoring"

Electroencephalography, the continuous recording of electrical brain activity via scalp electrodes, used to diagnose seizure disorders, detect non-convulsive status epilepticus, and monitor brain function in comatose patients

"The neurology nurse maintained electrode placement and skin integrity during 72-hour continuous EEG monitoring and flagged a period of rhythmic theta activity for urgent neurologist review."

"MRI brain"

Magnetic resonance imaging of the brain providing detailed soft-tissue contrast to identify lesions, ischaemia, demyelination, haemorrhage, and structural abnormalities not visible on CT

"The nurse screened the patient for contraindications to MRI brain including metallic implants, pacemakers, and claustrophobia, and coordinated sedation for the patient with severe agitation."

"neurorehabilitation"

An interdisciplinary programme of physiotherapy, occupational therapy, speech therapy, psychology, and nursing care aimed at maximising recovery of neurological function and independence after brain or spinal cord injury

"The neurorehabilitation team set collaborative goals with the patient following a traumatic brain injury, targeting independent transfers, safe swallowing, and return to communication within six weeks."

"swallowing assessment"

A structured clinical evaluation by a speech and language therapist or trained nurse to determine whether a neurological patient can swallow safely, guiding decisions about diet texture and enteral feeding

"The speech therapist completed a formal swallowing assessment using standardised tools and recommended a pureed diet with thickened fluids to reduce aspiration risk in the post-stroke patient."