Decorticate posture

Decorticate posture is an abnormal posturing in which a person is stiff with bent arms, clenched fists, and legs held out straight. The arms are bent in toward the body and the wrists and fingers are bent and held on the chest.

This type of posturing is a sign of severe damage in the brain. People who have this condition should get medical attention right away.

Considerations

Decorticate posture is a sign of damage to the nerve pathway in the midbrain, which is between the brain and spinal cord. The midbrain controls motor movement and many other important functions. Although decorticate posture is serious, it is usually not as serious as a type of abnormal posture called decerebrate posture.

The posturing may occur on one or both sides of the body.

Causes

Causes of decorticate posture include:

• Bleeding in the brain from any cause
• Brain stem tumor
• Stroke

  Stroke

  A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...

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• Brain problem due to drugs, poisoning, or infection
• Traumatic brain injury
• Brain problem due to liver failure

  Brain problem due to liver failure

  Loss of brain function occurs when the liver is unable to remove toxins from the blood.  This is called hepatic encephalopathy (HE). This problem ma...

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• Increased pressure in the brain from any cause

  Increased pressure in the brain

  Increased intracranial pressure is a rise in the pressure inside the skull that can result from or cause brain injury.

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• Brain tumor
• Infections, such as meningitis

  Meningitis

  Meningitis is an infection of the membranes covering the brain and spinal cord. This covering is called the meninges.

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• Reye syndrome (sudden brain damage and liver function problems that affects children)

  Reye syndrome

  Reye syndrome is characterized by sudden (acute) brain damage and liver function problems. This condition does not have a known cause. This syndrome...

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• Brain injury from lack of oxygen

When to Contact a Medical Professional

Abnormal posturing of any kind usually occurs with a reduced level of alertness. Anyone who has an abnormal posture should be examined right away by a health care provider and treated right away in a hospital.

What to Expect at Your Office Visit

The person will receive emergency treatment. This includes getting a breathing tube and breathing assistance. The person will be admitted to the intensive care unit.

After the condition is stable, the provider will get a medical history from family members or friends and a more detailed physical examination will be done. This will include a careful examination of the brain and nervous system.

Medical history questions may include:

• When did the symptoms start?
• Is there a pattern to the episodes?
• Is the body posture always the same?
• Is there any history of a head injury or drug use?
• What other symptoms occurred before or with the abnormal posturing?

Tests that may be done include:

• Blood and urine tests to check blood counts, screen for drugs and toxic substances, and measure body chemicals and minerals
• Cerebral angiography -- a dye and x-ray study of blood vessels in the brain

  Cerebral angiography

  Cerebral angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the brain.

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• MRI or CT scan of the head

  MRI

  A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...

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  CT scan of the head

  A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.

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• Electroencephalogram (EEG) brain wave testing

  Electroencephalogram

  An electroencephalogram (EEG) is a test to measure the electrical activity of the brain.

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• Intracranial pressure (ICP) monitoring

  Intracranial pressure

  Intracranial pressure (ICP) monitoring uses a device placed inside the head. The monitor senses the pressure inside the skull and sends measurements...

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• Lumbar puncture to collect cerebrospinal fluid

  Lumbar puncture

  Cerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. CSF acts as a cushion, protecting the b...

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The outlook depends on the cause. There may be brain and nervous system injury and permanent brain damage, which can lead to:

• Death
• Coma
• Inability to communicate
• Paralysis
• Seizures

  Seizures

  A seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...

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