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Neurological Glossary

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(Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy); the most common form of hereditary stroke disorder. A progressive illness, which can manifest as migraine, TIA, stroke and mood disorders. May be slowed down through the use of anticoagulant drugs.

Calcarine cortex
Primary visual cortex located in the occipital lobe (striate area 17)

Tiny blood vessels.

Cardio-embolic stroke
Stroke due to a clot that has formed in the heart and travelled to the brain.

Carotid sinus
Arterial baroreceptor located at the bifurcation of the external and internal carotid arteries that regulates arterial pressure and heart rate in response to changes in stretch and transmural pressure

Referring to menses; with regard to women with epilepsy or migraine, a tendency for seizures/migraines to occur around the time of menses

Sudden loss of postural tone, often triggered by an emotional stimulus and resulting in falls to the floor; seen in narcolepsy

Cauda equina
(�horse�s tail�) collection of intradural spinal nerve roots caudal to the spinal cord that supply the lower limbs and pelvis; since this structure is part of the peripheral nervous system, lesions produce lower motor neuron deficits

Toward the tail

Portion of the basal ganglia that lies in the floor of the lateral ventricle

Cavernoma (cavernous malformation)
Vascular malformations composed primarily of large venous channels without a clear-cut arterial component

Cavernous sinus
Paired, venous structures located on either side of the sella turcica that receive blood from the superior and inferior orbital veins and drain into the superior and inferior petrosal sinuses; contains the carotid artery and its sympathetic plexus, the oculomotor nerves (III, IV, VI), and the ophthalmic branch of V; lesions typically result in ophthalmoplegia, orbital congestion, and proptosis

Central chromatolysis
Regenerative response to axonal injury consisting of neuronal swelling, nuclear eccentricity, and loss of Nissl substance

Central cord syndrome
Spinal cord injury syndrome associated with damage to the central portion of the spinal cord characterized by bilateral weakness of distal>proximal muscles in the arm>leg, bladder dysfunction, and a variable degree of sensory loss below the level of injury.

Central herniation
Downward displacement of the cerebral hemispheres pushing the diencephalon and midbrain through the tentorial notch; symptoms classically follow a rostrocaudal deterioration

Central nervous system (CNS)
Brain and spinal cord

Central post-stroke pain (CPSP)
Also called thalamic pain or neuropathic pain syndrome; where all stimuli cause a pain reaction, often described as shooting or burning sensations. May be experienced after stroke in the affected side.

Central sulcus
Prominent sulcus on the dorsolateral aspect of the cerebral hemispheres formed by the precentral and postcentral gyri; defines the boundary between the frontal and parietal lobes

Centrally-acting drugs
Medicines that act on the brain or central nervous system

Centrum semiovale
Expansive region of white matter in the dorsal core of the frontal and parietal lobes, named because of its central position in the forebrain and its semi-oval shape

Relating to the head

Cerebellar peduncle
Three major white matter structures containing #efferent and afferent axons of the cerebellum; named the inferior, middle, and superior cerebellar peduncles

Cerebellar tonsil
Lateral portions of the uvula located in the posterior lobe of the cerebellum

Cerebellopontine angle
Space located at the junction of the cerebellum, pons, and medulla containing cranial nerves V-XI, blood vessels, the flocculus of the cerebellum, and choroid plexus

The part of the brain that controls fine (delicate) movement and may also play a part in higher mental functions.

Cerebral amyloid angiopathy (congophilic angiopathy)
Vascular disorder in which beta amyloid protein is deposited within the media and adventitia of small- to medium-sized meningeal and cortical blood vessels, causing them to become brittle and break; important cause of predominantly lobar intracerebral hemorrhage in the elderly

Cerebral aqueduct
Portion of the ventricular system that lies in the dorsal midbrain and connects the third and fourth ventricles

Cerebral arteriosclerosis
Thickening and hardening of the arteries within the brain.

Cerebral atherosclerosis
Build-up of fatty deposits in the inner wall of cerebral arteries; form of cerebral arteriosclerosis

Cerebral atrophy
The shrinking of the brain or brain cells.

Cerebral autosomal dominant arteriopathy with subcortical infarcts & leukoencephalopathy (CADASIL)
Familial arterial disease of the brain caused by mutations in the Notch3 gene and consisting of recurrent subcortical strokes starting in midadult life, dementia, depression, and migraine

Cerebral cortex
The thin outer layer of the cerebrum, a convoluted "crust" lying over and around most of the structures of the brain, in which most of its higher functions take place.

Cerebral haemorrhage
Bleeding from a ruptured blood vessel in the brain.

Cerebral hemisphere
Symmetrical half of the cerebrum as separated by the sagittal sulcus and containing the cerebral cortex, basal ganglia, hippocampus, and amygdala

Cerebral Palsy
A disorder of movement and posture due to a non-progressive defect or lesion to the immature brain

Cerebral peduncle (crus cerebri)
White matter tracts (corticospinal and corticobulbar) on the ventral surface of the midbrain containing the efferent axons of cerebral cortex that project to brainstem and spinal cord

Cerebral perfusion pressure (CPP)
Mean arterial pressure (MAP) � intracranial pressure (ICP)

Cerebral salt wasting
Centrally-mediated hypovolemic hyponatremia associated with negative sodium balance that occurs in approximately 30-50% of patients with subarachnoid hemorrhage despite their being given maintenance volumes of fluid. Excessive sodium loss is thought to be due to impaired sodium reabsorption in the proximal tubule and may be caused by disruption of sympathetic input to the kidneys, production of a circulating natriuretic factor, or both

Cerebral Thrombosis
Formation of blood clot in an artery of the brain

Inflammation of the brain

Cerebrospinal fluid (CSF)
Clear, colourless fluid bathing the entire surface of the CNS, most of which is secreted by the choroid plexus and the remainder by brain capillaries; flows through the ventricles and out into the subarachnoid space via the foramen of Magendie in the midline and the two foramina of Luschka at the lateral margins of the roof of the 4th ventricle, then is absorbed through the arachnoid villi in the walls of dural sinuses and returned to the systemic circulation

The largest part of the brain, made up of the left and right hemispheres (sides).

Charcot-Bouchard aneurysm
Aneurysmal dilation of small intraparenchymal vessels commonly seen in the brains of patients with hypertensive haemorrhage

Charcot-Marie-Tooth Disease (CMT)
An inherited neurological disorder damaging motor and sensory peripheral nerves and causing muscle weakness and reduced sensation in the legs, feet and hands

Charcot joint
Progressive destruction and deformity of bone and soft tissue at weight bearing joints due to severe sensory or autonomic neuropathy

Relating to the hand

Chiari malformation
CNS disorder characterized by cerebellar elongation and protrusion through the foramen magnum into the cervical spinal cord. Type I consists of caudal displacement of the medulla and inferior pole of the cerebellar hemispheres through the foramen magnum. Type II=type I + hydrocephalus and lumbosacral spina bifida. Type III involves herniation of the entire cerebellum through the foramen magnum with a cervical spina bifida cystica. Type IV involves cerebellar hypoplasia

A fatty substance made in the liver and also present in some foods, which is vital to the body's normal functioning, but if present in excess, can be deposited in the wall of the

Uncontrollable, small, jerky movements, usually of toes and fingers

Involuntary movements showing features of both chorea and athetosis

Choroid plexus
Intraventricular structure that secretes cerebrospinal fluid

Choroid plexus papilloma
Histologically benign intracranial tumor of neuroectodermal origin that is most commonly located in a ventricle (lateral>fourth>third), where it often presents with non-communicating hydrocephalus due to overproduction of CSF; may also be seen in the cerebellopontine angle

Chronic daily headache
Headache disorder consisting of frequent headache occurring 15 or more days per month and including headache associated with medication overuse

Chronic pain
Pain which persists over a long period of time and is resistant to most medical treatments

Chronic paroxysmal hemicrania
Indomethacin-responsive headache disorder characterized by the occurrence of multiple daily attacks lasting 5 to 30 minutes of severe unilateral head pain often associated with autonomic phenomenon (eye tearing, eye redness, eyelid edema, nasal congestion, runny nose); also known as atypical cluster headache

Developing over months to years; implies gradual deterioration as occurs with degenerative diseases like Alzheimer disease, Huntington disease, etc.

Cingulate gyrus
Cortical component of the limbic system located on the medial aspect of the hemisphere superior to the corpus callosum; involved in emotional and cognitive processing

Cingulate herniation
Horizontal displacement of a cerebral hemisphere due to an expanding lesion that forces the cingulate gyrus under the falx cerebri, compressing the internal cerebral vein and the contralateral hemisphere

Circadian rhythm
Innate daily fluctuation of physiological or behavioral functions, including sleep-wake states generally tied to the 24-hour daily dark-light cycle

Circle of Willis
The main arterial trunk located at the base of the brain where the two internal carotid arteries and the basilar artery join, allowing blood to be redistributed to the anterior, middle, and posterior cerebral arteries

Circulatory problems
Impairment or malfunction of a part of the circulatory system, ie. the heart, lungs and blood vessels.

Constraint-induced Movement Therapy (CIT)
An intensive movement rehabilitation programme, developed by Professor Edward Taub which involves applying constraint to the unaffected arm while rehabilitation is applied on the affected side.

�Clasp knife�
Spring-like resistance to passive extension at the elbow or flexion at the knee that increases up to a certain length and force before suddenly relaxing as the Golgi tendon organ is activated; sign of spasticity

Claude Syndrome
Ipsilateral oculomotor palsy and contralateral ataxia and hemichoreoathetosis due to a dorsal midbrain tegmental lesion affecting the III nerve fascicles, superior cerebellar peduncle, and red nucleus

Thin plate of gray matter lying in the white matter between the insula and the basal ganglia that modulates cortical activity

Clay shoveler�s fracture
Typically stable fracture through a spinous process due to hyperextension injury

Clinical psychologist
Health professional who assesses and treats psychological dysfunction, disorder and distress, and may specialise in difficulties arising from stroke or neurological impairment

Clonic seizure
Generalized seizure characterized by jerking movements on both sides of the body

Rhythmic contraction relaxation tremor due to cyclic alternations of the spindle stretch reflex and the Golgi tendon organ reflex; indicative of exaggerated stretch reflexes

Anti-platelet drug used to stop clots from forming, also known as plavix.

Cluster headache
Primary headache syndrome characterized by intense, unilateral orbital, supraorbital, and/or temporal pain lasting 15-180 minutes and occurring in "clusters" up to several times per day for a period of one or more months before going into "remission" for months or years; diagnosis requires one or more of the following autonomic abnormalities ipsilateral to the headache: conjunctival injection, lacrimation, ptosis, miosis, eyelid edema, nasal congestion, rhinorrhea, or facial sweating

Central nervous system

CNS metastasis
Metastatic tumours typically spread by a haematogenous route and found at the junction between gray matter and white matter where they are trapped by the acute angle branching of the microvasculature

The function of processing information and applying knowledge.

Cognitive functions
Processes requiring thought and intelligence, such as attention, perception, learning, memory, comprehension, judgement and decision making.

Ratchety movement due to superimposition of tremor on rigidity

Coital headache
Indomethacin-responsive headache disorder characterized by sudden, severe, throbbing, occipital headache that occurs just before or during orgasm

State of unarousable unresponsiveness with closed eyes, no speech, and no purposeful movements

Common carotid artery
Artery that arises from the brachiocephalic artery on the right and from the aortic arch on the left, ascending in the neck and dividing at the upper border of the thyroid cartilage into the external and internal carotid arteries to supply the head and neck

Communicating hydrocephalus
Blockage of CSF flow outside the ventricular system, either at the level of the arachnoid granulations or because of overproduction of CSF (e.g., from a choroid plexus papilloma) that exceeds the rate of absorption

Community physiotherapist
Provides a local or domiciliary service (where patients are housebound) for adults with physical health difficulties or rehabilitation needs. Usually works as part of a team providing assessment and treatment for difficulties with mobility, pain and other problems.

Adapting to an impairment in order to perform a task successfully

Complementary (therapy)
Various treatments, often based on traditional medicine, which are practised in conjunction with 'orthodox' or 'mainstream' medical treatment to aid recovery from illness. Opinions vary on their effectiveness. May affect other treatments and should be used with caution and only after taking medical advice.

Complex partial seizure
Partial seizure in which consciousness or awareness is impaired; epileptic discharge either originates in limbic structures (hippocampus) or spreads to them from neocortex, especially from the frontal lobe

Complex tic
Distinct, coordinated patterns of successive movements involving several muscle groups; complex vocal tics include meaningful syllables, words, or phrases; complex motor tics are coordinated or sequential patterns of movement such as twirling a pencil or touching other people

Computed Tomography (CT)
The X-ray technique most commonly used to examine the brain. Sometimes referred to as CAT - computed or computerised axial tomography.

The ability to direct and focus one's thinking in whatever direction one would intend.

Traumatic closed head injury that results in temporary impairment of neurological function, e.g., transient loss of consciousness

Unconscious fabrication of experiences and events to cover gaps in memory. May be caused by damage to the anterior communicating artery and frontal area of the brain.

Conduction aphasia
Selective impairment of the ability to repeat due to a lesion of the arcuate fasciculus, which connects Wernicke�s area to Broca�s area

Conduction block
Failure of impulse conduction along an anatomically intact axon; characteristic of demyelinating neuropathy

Conductive Education
A learning system which can enable some children with cerebral palsy to function more independently

�present at birth� i.e. a condition which originates prenatally

Automatic control of bladder and bowel function. Loss of one or both (incontinence) may happen for a time after stroke.

Opposite to the site of impact

Permanent shortening of muscle and tendon resulting from spastic tightening of muscles over a long period

Located on the opposite side of the body (brain)

Oedematous brain lesion containing punctuate parenchymal haemorrhages on the surface of the brain that may extend bi-directionally into the white matter and the subdural and subarachnoid spaces; occur at the site of impact (coup contusion) with direct trauma and at a site opposite to the site of impact (contracoup contusion) with acceleration/deceleration injury

Conus medullaris
Caudal-most part of the spinal cord located between the first and second lumbar vertebrae. Since this structure is part of the spinal cord but is in close proximity to spinal nerve roots, lesions often produce both upper motor neuron and lower motor neuron deficits

Coordinated inward movement of the eyes in order to fixate on a near object

Convergence-retraction nystagmus
Form of nystagmus consisting of jerking eye movements inward and backward; associated with dorsal midbrain lesion

Uncontrolled, often obsessive use of obscene language occasionally seen in Tourette syndrome

Vertical plane from head to foot and parallel to the shoulders

Corona radiata
Fan-like arrangement of fibres projecting from all aspects of the cerebral cortex and converging toward the thalamus where they will form the internal capsule

Corpus callosum
Large fibre structure that makes connections between homotopic regions of the cerebral hemispheres; bend at its anterior limit is called the genu; bend at its caudal end is called the splenium; portion between the two is called the body.

Correct positioning
After stroke where one side of the person is weak or paralysed, care should be taken with their movement and positioning, to ensure that they are safe and properly supported. A physiotherapist should be able to advise.

Referring to the cerebral cortex, the outermost layer of the cerebrum

Cortical blindness
Apparent lack of visual functioning in spite of anatomically and structurally intact eyes due to bilateral lesions of the primary visual cortex

Corticobasal degeneration
Progressive neurological disorder characterized by nerve cell loss in the cerebral cortex and basal ganglia and producing parkinsonism, dementia, visual-spatial impairment, alien hand syndrome, apraxia, and myoclonus

Corticobulbar tract
Axons originating in the posterior frontal lobe and projecting to lower motor neurons in the brainstem

Corticospinal tract (pyramidal tract)
Motor pathway responsible for voluntary movement that arises from primary motor cortex, area 6, and somatosensory cortex and descends through the corona radiata, internal capsule, cerebral peduncle, medullary pyramid (where it decussates), and spinal cord to alpha motor neurons in spinal cord gray matter

Cough headache
Indomethacin-responsive headache disorder characterized by transient, severe, explosive head pain upon coughing, sneezing, weight lifting, bending, or stooping

Lesion at the site of impact

Cowdry A inclusion bodies
Eosinophilic nuclear inclusions surrounded by a clear halo in neurons or glial cells occurring in herpes simplex encephalitis

Cowdry B inclusion bodies
Large glassy eosinophilic nuclear inclusions occurring in herpes simplex encephalitis

Craft palsy
Dystonia occurring in the setting of a highly learned skilled task, e.g., writer�s cramp, yips in golfers

Surgical removal of a section of bone (bone flap) from the skull for the purpose of operating on the underlying tissues or relieving intracranial pressure, in which the bone flap is not replaced at the end of the procedure

Suprasellar WHO grade I tumour of children/young adults that causes significant morbidity and mortality; characterized histologically by basal palisading, wet keratin, and infiltrative fingers of tumour that make it difficult to cure

Surgical repair of a defect or deformity of the skull; replacement of a bone flap

Craniorachischisis totalis
Fatal neural tube defect consisting of total failure of neurulation; a neural plate-like structure is entirely exposed without overlying bony or dermal covering

Premature closure at birth of one or more cranial sutures, which limits head growth perpendicular to the suture(s);

Surgical removal of a section of bone (bone flap) from the skull for the purpose of operating on the underlying tissues, in which the bone flap is replaced at the end of the procedure

Creatine kinase
Enzyme that catalyzes the conversion of creatine to phosphocreatine and is released into the blood by tissues�particularly muscle�that consume adenosine triphosphate (ATP) rapidly; elevated levels are seen in myopathy

Cremasteric reflex
Superficial (cutaneous) reflex elicited by stroking the superior and medial part of the thigh in a downward direction; normal response is contraction of the cremasteric muscle that pulls up the scrotum and testis on the side stroked; dependent on nerve roots L1 and L2

A medical term to describe the grating, crackling or popping sounds and sensations experienced under the skin and joints.

Creutzfeldt-Jakob disease
Fatal prion disease characterized by spongiform changes in the brain, progressive dementia, psychiatric changes, and myoclonus; form of spongiform encephalopathy

Crossed adductor reflex
Reflex contraction of the adductor magnus caused by tapping the opposite knee; indication of hyperreflexia on the side of the adductor contraction; commonly thought to be due to stimulation of the adductor muscle on the hyperreflexive side through slight jarring of the pelvis

�Crossed signs�
Ipsilateral cranial nerve signs and contralateral long-tract signs: implies lesion of the brainstem; sometimes used synonymously with dissociated sensory deficits due to spinal cord or brainstem lesions

Relating to the leg

Occurring without known cause; in the context of epilepsy, indicates cases in which a lesion and distinct pathogenesis are presumed

CT/ CAT Scan
Diagnostic technique using a combination of computer and X-rays [Computed Axial Tomography] - provides cross-sectional images of tissue which are clearer and more detailed than X-rays alone with minimal exposure to radiation

The abbreviation for 'cerebro-vascular accident' meaning stroke. The term is widely used but may cause confusion.

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