Essential Medical Definitions: Lymphedema, Stroke, Spinal Cord Injury

Lymphedema Clinical Presentation

• Increased limb volume:
  • Worsens during the day and is lower at night.
  • Decreases with elevation.
• Lower extremity involvement:
  • Often respects the sole of the foot.
  • Typically begins in the ankle.
  • Can progress to resemble an elephant's foot (elephantiasis), which is usually painless.

Temporal Clinical Classification of Ischemic Stroke

Transient Ischemic Attack (TIA)

• Episode of focal neurological deficit, short-term.
• Total recovery within 24 hours.
• No cerebral parenchymal necrosis.
• Current definitions often include standard imaging tests.

Reversible Ischemic Neurological Deficit (RIND)

• Neurological deficit lasting 24 hours and less than 4 weeks.

Established Stroke

• Focal neurological deficit remains unchanged since its onset.

Progressive or Evolving Stroke

• Worsening of focal symptoms during the hours following its onset.

Spinal Cord Injury: Levels of Impairment

The terms below describe the general level of injury and resulting loss of function in patients with spinal cord injuries:

Pentaplegia

• Injury between the medulla oblongata and the first cervical segment (C1).
• Affected areas:
  • Neck muscles (except the platysma, which is innervated by the facial nerve).
  • Upper and lower extremities.
  • Thorax and diaphragm.
  • Pelvic organs: urinary and fecal incontinence, sexual dysfunction.
• Anesthesia of the entire body and head, except for the perinasal, perioral, and bulbar areas corresponding to the trigeminal sensory nucleus.
• Survival is conditional on respirator dependence and, if possible, diaphragmatic electrical stimulation.

Respiratory Quadriplegia

• Injury at cervical segments C2 and C3.
• Affected areas:
  • Upper and lower extremities.
  • Thorax and diaphragm.
  • Pelvic organs.
• Survival is conditional on respirator dependence and, if possible, diaphragmatic electrical stimulation.

Tetraplegia (Quadriplegia)

• Decrease or loss of motor and/or sensory function in cervical segments (C4-C7) of the spinal cord.
• Affected areas:
  • Upper limbs.
  • Trunk.
  • Legs.
  • Pelvic organs.
• The diaphragm and respiratory muscles are typically functioning.

Paraplegia

• Decrease or loss of motor and/or sensory function in thoracic, lumbar, or sacral segments of the spinal cord.
• Upper limb function is preserved.
• Affected areas may include:
  • Trunk.
  • Legs.
  • Pelvic organs.