Neurovascular Terminology

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AVF (arteriovenous fistulae)

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an abnormal, direct passageway between an artery and a vein.

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AVM (arteriovenous malformation)

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an abnormal collection of blood vessels in which blood flows directly from arteries to veins without an intervening capillary bed.

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Adventitia

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the outermost lining of a blood vessel, composed primarily of connective tissue and elastic fibers; provides elastic and structuralstrength to the artery.

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A(no)gno(know)sia

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loss of ability to recognize objects, people, sounds, shapes orsmells. Usually classified according to the sense or senses affected. Symptom common to damage to parietal lobes of cerebral hemispheres

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Anastomosis

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a connection between two vessels or tubes such as arteries.

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Aneurysm

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a thin-walled outpouching or dilation of a blood vessel.

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Angiogram

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also referred to as arteriogram; a radiographic technique used for visualization of the blood vessels using standard radiographic methods in conjunction with the intra arterial injection of iodinated contrast medium.

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Anticoagulants

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medications that prevent or slow blood coagulation.

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Antiplatelets

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medications that prevent or slow aggregation of platelets,a critical step in the blood clotting process.

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A(no)phasia(speak)

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loss of ability to speak or write; loss of ability to understand speech or written words.

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A(no)praxia(action)

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inability to perform purposeful movements.

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Arachnoid mater

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the thin, delicate membrane interposed between the dura mater and the pia mater of the entire brain and with them constitutingthe brain meninges — a protective covering of the brain made up of delicate, elastic tissues and blood vessels.

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Arrhythmia

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irregular heartbeat.

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Athero(fatty/plaque)sclerosis(hardening

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arterial disorder characterized by thickening, loss ofelasticity and calcification of arterial walls resulting in decreased bloodsupply.

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A(no)tax(coordination)ia

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lack of coordination in bodily movements

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A(no)trophy(development)

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a “wasting away”; a diminution in the size of a cell, tissue,organ or part.

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Benign

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not malignant, not recurrent, favorable for recovery.

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Brain stem

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Located athe the front of the cerebellum and holds up the cerebrum..

It consists of the medulla oblongata, pons, and midbrain.

It is a relay station between the body and the cerebral cortex.

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Bruit

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an abnormal sound or murmur heard while auscultating (listening to) an organ or body

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CSF (cerebral spinal fluid)

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the fluid that flows through and protects the four ventricles of the brain, the subarachnoid space and the spinalcanal.

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CT (computed tomography)

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a computerized x-ray device that produces images of cross section of the brain. A dye may be used to help visualize abnormal tissue.

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Capillary

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One of the minute vessels connecting the arterioles and venules.
The walls are a semipermeable membrane for interchange of various substances between the blood and tissue fluid.

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Carotid “siphon”

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The carotid siphon is an S-shaped part to the ICA.

It begins at the posterior bend of the cavernous ICA and ends at the ICA bifurcation. Cavernous and supra clinoid portions of the ICA forms carotid siphon

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Catheter

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A hollow, flexible tube for insertion into a body cavity, duct, or vessel.

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Caudal

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Toward the distal end of the spine.

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Cerebellum

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Located on the back of the brainstem, below the occipital.
Controls balance and coordination and our fine motor skills.
It consistsof a median lobe and two lateral lobes.

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Cerebral aneurysm

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A weak, bulging spot on a brain artery wall.
Also called a brain or intracranial aneurysm.

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Cerebrum

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Forms the bulk of the brain and is divided into 2 hemispheres. The 2 hempispheres are connected by the corpus callosum. The surface contains billions of neurons and glia that make up the cerebral cortex (grey matter).

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Circle of Willis

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Allows blood that enters by either internal carotid (anterior circulation) or vertebral arteries (posterior circulation) to be distributed to any part of either hemisphere. Allows communicationbetween anterior and posterior circulation.

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Congenital

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present at and existing from the time of birth.

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Contrast

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a radiopaque material used to visualize arteries and veins in an angiogram.

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Coumadin®

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tradename for the anticoagulant Warfarin Sodium.

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Craniotomy

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surgical procedure where a section of the skull cap istemporarily removed.

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DEcErEbratE posture

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Arms are down at the sides, hands form e's. This condition usually indicates compression/damage of the brainstem (mid brain or pons).

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Digital subtraction angiography

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subtraction of bony images froman angiographic image to allow clearer visualization of opacified vessels.

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DeCORticate posture

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Elbows and arms are pulled into the body's core. This indicates a lesion in the mesencephalic region of the brain, cervical spinal tract, or cerebral hemisphere.

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Dura mater

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The outermost, toughest, of the meninges.
Covers and protects the brain and spinal cord.

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Dys(difficulty)arthria(articulate)

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Impairment of speech caused by damage or impairment of the tongue or speech muscles. May be caused by pressure on the brainstem or elsewhere in the posterior fossa.

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Dys(difficulty)phagia(swallowing)

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difficulty swallowing.

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Dys(difficult)phasia(speech)

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Language disorder
Inability to speak words which one has in mind or to think of correct words.
Inability to understand spoken orwritten words.

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Dys(difficult)plasia(formation)

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abnormality in development of a tissue or organ.

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Dys(difficult)pnea(breathing)

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difficulty breathing.

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EEL (External elastic lamina)

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Thin, elastic layer between the media and adventitia of an artery.
Not present in intracranial arteries.

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Edema

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swelling due to an excess of water

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Embolization

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Coiling.

A technique that seals off the aneurysm and stops further blood from entering. This treatment is done endovascularly.

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Embolus

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a foreign object, quantity of gas, a bit of tissue or thrombus that circulates in the bloodstream until lodging in a vessel.

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Endothelium

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The layer of epithelial cells that lines the cavities of the heart and of the blood and lymph vessels, and the serous cavities of thebody.

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Endovascular

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within the vascular system.

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Epidemiology

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the study of the distribution of disease and its impact upon a population using measures such as incidence, prevalence, and mortality.

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Eti(cause)ology

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the study of cause of disease

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Extracranial

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outside the cranial cavity

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Fibr(fiber)inolysis(breakdown)

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the dissolution of fibrin by enzymatic action.

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Fluoroscopy

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an examination by means of the fluoroscope to visually observe the form and motion of blood vessels by means of x-ray shadows projected on a fluorescent screen.

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Glasgow outcome scale (GOS)

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The Glasgow Outcome Score applies to patients with brain damage allowing the objective assessment of their recovery in five categories. This allows a prediction of the long-term course of rehabilitation to return to work and everyday life.

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Guide catheter

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Flexible tubes introduced into the patient’s carotid artery in the neck to function as a working channel through which devices, like microcatheters, may be introduced into the brain.

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Guidewire

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A thin, usually flexible wire that can be inserted into a confined or tortuous space to guide and facilitate passage of instrumentation, such as a catheter.

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Hematoma

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A collection of extravasated blood trapped in the tissues ofthe skin or in an organ.

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Hemiparesis

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muscle weakness on one side of the body.

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Hemodilution

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a reduction in the concentration of blood cells in a givenvolume of blood.

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Hemodynamics

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the study of the movements of the blood and of theforces concerned therein.

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Hemorrhage

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a loss of a large amount of blood in a short amount oftime.

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Hemorrhagic stroke

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A stroke caused by a ruptured blood vessel and characterized by bleeding in or surrounding the brain.

Maybe caused by a subarachnoid hemorrhage from a ruptured cerebral aneurysm.

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Hemostasis

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the arrest of bleeding, either by the physiological properties of vasoconstriction and coagulation or by surgical means. Interruption of blood flow through any vessel or to any anatomical area.

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Heparin

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an anionic mucopolysaccharide that acts as an anticoagulant and is used for prevention and treatment of venous and arterial thromboembolism.

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Hydro(water)cephal(head)us

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excess water in the brain due to blockage of CSF flow, increased production or reduced absorption.

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Hyper(excess)plasia(development)

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an increase in the number of cells in a body part

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Hypertension

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high blood pressure

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Hyper(excess)volemia(blood volume)

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an increase in the amount of extracellular fluid.

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Hunt & Hess grade

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a neurological scale used to determine the patient’s surgical risk following the hemorrhage of an aneurysm.

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ICAD (intracranial atherosclerotic disease)

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the build up of plaque on the inside walls of arteries within the brain.

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ICP (Intracranial pressure)

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pressure within the cranium that can becaused by increased blood or fluid in a closed, non-expandable space.

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IEL (Internal elastic lamina)

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thin, elastic layer between the intimal and medial layers of an artery.

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IVUS (intravascular ultrasound)

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ultrasound within a vessel

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Infarct

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a localized area of necrosis (death) in a tissue, vessel, or organ resulting from tissue an(no)oxia(oxygen) caused by the cessation of blood flow.

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Intima

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the innermost lining of an artery, composed of endothelial cells. Provides a smooth, thrombo iresistant surface and is nourished by the blood flowing through the artery.

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Intracerebral hemorrhage

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bleeding within the cerebrum as a result of trauma or aneurysm rupture.

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Intracranial

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within the cranial cavity or skull

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Ischemia

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lack of oxygen due to decreased blood supply to a body organ or part.

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Ischemic penumbra

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the region surrounding dead brain tissue that is close to cell death, but still potentially viable

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Ischemic stroke

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stroke caused by a lack of blood supply and subsequent lack of oxygen to affected brain tissue.

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MRA (magnetic resonance angiography)
uses blood

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uses blood flow as an intrinsic contrast agent and a magnetic field to produce detailed images of brain tissue and cerebral arteries.

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MRI (magnetic resonance imaging)

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a computerized scanning devic eutilizing a magnetic field and radio waves.

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Malignant

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tending to become progressively worse and possibly result in death.

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Media

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Middle layer of an artery, composed of smooth muscle tissue.
Provides strength to the artery by allowing constriction and/or dilation.

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Medical therapy

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The use of pharmacological agents.
Also referred to as medical management or medical treatment.

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Meninges

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The three membranes covering the brain and spinal cord for protection: dura mater, arachnoid, and pia mater.

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Mass effect

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Symptoms produced by compression or displacement of brain tissue, specific to the brain territory around a physical mass.

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Meningioma

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a hard, usually vascular tumor, occurring mainly along themeningeal vessels and superior longitudinal sinus, invading the dura andskull and leading to erosion and thinning of the skull.

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Microcatheter

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a very small catheter used to deliver diagnostic and therapeutic agents such as devices used in the endovascular treatment of cerebral aneurysms. Over-the-wire microcatheters follow along a guidewire to the area of the body for treatment. Flow-directed microcatheters utilize the forward blood flow to reach their destination in the body.

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Myelo(spine)graphy(process of recording)

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A radiographic process by which the spinal cord and spinal subarachnoid space are viewed and photographed after the introduction of contrast media.

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Neo(new)plasm(growth)

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tumor: any new and abnormal growth, specifically one inwhich cell multiplication is uncontrolled and progressive.

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Neuro(nerve)angio(vessel)graphy(process of recording)

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the study of blood vessels in the brain.

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Nid(nest)us

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the point of origin or focus of a morbid process

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Non-ruptured aneurysm

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an aneurysm that has not hemorrhaged.

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PET
(positive emission tomography)

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a scanning technique using low-dose radioactive glucose to measure metabolic activity of an organ.

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Patho(disease)genesis(forming)

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the source or cause of a disease

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Pia mater

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the inner most and most delicate of the three meninges covering the entire brain and spinal cord. Contains many blood vessels that reach deep into the surface of the brain.

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Plaque

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a fatty deposit inside an arterial wall, made up of plasma lipids, cholesterol, connective tissue fibers and other cells in the intima of the vessel; an abnormal patch on or inside the body.

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RIND
(reversible ischemic neurologic deficit)

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A stroke that a patient recovers from in about 3 weeks.

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Radiosurgery

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a technique that uses focused beams of radiation to treat AVMs that are sufficiently small and located in accessible areas ofthe brain. It causes scarring in the blood vessels of the AVM, therebyeliminating it.

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Rebleed

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to bleed again after an initial bleed such as in an aneurysmrupture.

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Recanalization

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regrowth of an aneurysm.

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Re(again)stenosis(tightening)

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occurs after a vessel has been treated with angioplasty orstenting. It is the repair process caused by mechanical injury inducedby ballooning and stenting and is different than the original plaque oratherosclerotic lesion.

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Roadmap

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superimposing a “real time” image over a stored subtracted reversed image, to enable more effective navigation through the vasculature

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Ruptured aneurysm

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An aneurysm that has hemorrhaged prior to coil treatment.

Acute rupture = occurred within the last fifteen days
Non-acute rupture = occurred over fifteen days ago

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SAH (subarachnoid hemorrhage)

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An intracranial hemorrhage into the CSF filled subarachnoid space.

The pathologic hallmark of aneurysm rupture as cerebral arteries are within the subarachnoid space.

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SPECT (single photon emission computed tomography)

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a variationof CT imaging

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Shunt

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a diversion or redirection of bodily fluid from one cavity or vesselto another.

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Stenosis(tightening)

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A narrowing of the artery lumen generally due to thrombus,atherosclerotic plaque or vasospasm in the vessel.

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Stent

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A device used to support and maintain patency of a bodily cavity, channel, or vessel.

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Stroke

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Any disease process which results in the death of cells in anyregion of the brain. Cerebral vascular accident.

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Subarachnoid space

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between the arachnoid mater and pia mater of the brain, in which flows cerebrospinal fluid.

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Subdural space

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between the dura mater and the arachnoid mater of the brain.

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Systemic

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pertaining to or affecting the entire body as a whole

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TIA (transient ischemic attack)

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an episode of cerebrovascular insufficiency, usually associated with partial occlusion of an artery by atheroscleroticplaque or an embolism.

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Thrombo(clot)genesis(forming)

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clot formation

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Thrombo(clot)genic(produced by)

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producing or tendency to produce a clot.

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Thrombo(clot)lytics(breakdown)

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agents that lead to dissolution of a thrombus

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Thrombo(clot)embolism

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obstruction of a blood vessel with thrombotic material carried by the blood from the site of origin to plug another vessel.

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Thrombus

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an aggregation of platelets, fibrin, clotting factors, and cellular elements of blood that adheres to blood vessel walls

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Trans(through)cranial(cranium) Doppler

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noninvasive procedure in which a small probe isplaced against the skull to measure blood flow velocity through the cerebralarteries with high frequency sound waves.

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Tumor

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neoplasm: a new growth of tissue in which cell multiplication isuncontrolled and progressive

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Ultra(beyond)sono(sound)graphy(process of recording)

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the imaging of deep structures of the body by recordingthe echoes of pulses of 1-10 megahertz ultrasound reflected by tissueplanes where there is a change in density.

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Vaso(vessel)constriction

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constriction or narrowing of blood vessels.

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Vaso(vessel)spasm(sudden contraction)

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acute, abnormal narrowing of arteries due to irritation byblood in the subarachnoid space; often develops several days after ananeurysm rupture.

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Ventricles

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a small cavity or chamber such as in the heart or brain. Brainventricles manufacture and circulate cerebrospinal fluid.