Decorticate Posture: Causes, Symptoms, Diagnosis, Treatment, and Prevention
The decorticate posture can be seen as a sign of a serious brain injury or condition that requires immediate medical attention when there is damage or disruption to certain areas of the brain.
What is decorticate posture?
A decorticate posture is a reflexive body position a person may hold when they are unconscious or in a coma. It is not a voluntary movement, but a response to stimuli or pain.
-
The legs are straight and rigid, with the feet pointing inward and slightly downward.
-
The arms are bent at the elbows and held close to the chest, with the wrists curled and the hands clenched.
-
The head and neck may be arched backward or tilted to one side.
A decorticate posture usually affects both sides of the body, but it can also be asymmetrical, inconsistent, or change to another type of abnormal posture, such as decerebrate or opisthotonos, depending on the extent of brain damage.
What causes decorticate posture?
A decorticate posture is caused by damage or disruption to the nerves that connect the brain to the spinal cord. These pathways control body movements and reflexes. If these pathways are impaired, the body may adopt a decorticate posture as a default setting.
Some of the brain areas that are involved in decorticate posture are:
-
The cerebral cortex, which is the outer layer of the brain that is responsible for higher cognitive functions, such as thinking, reasoning, and memory.
-
The thalamus, which is a central structure that relays sensory and motor signals between the brain and the body.
-
The upper midbrain, which is the upper part of the brainstem that connects the brain and the spinal cord and regulates vital functions, such as breathing, heart rate, and consciousness.
Some of the conditions that can cause damage or disruption to these brain areas are:
-
Traumatic brain injury (TBI), which is a physical injury to the brain caused by a blow, a fall, a gunshot, or a car accident.
-
Stroke, which is a sudden interruption of blood flow to the brain, resulting in tissue death and loss of function.
-
Brain tumor, which is an abnormal growth of cells in the brain that can compress or invade the surrounding structures.
-
Brain infection, such as meningitis, encephalitis, or Reye’s syndrome, which is an inflammation of the brain or its membranes caused by bacteria, viruses, fungi, or toxins.
-
Brain swelling, which is an increase in the pressure inside the skull due to fluid accumulation, bleeding, or inflammation.
-
Drug overdose, poisoning, or liver failure, which can affect the brain’s metabolism and oxygen supply.
What are the symptoms of decorticate posture?
Decorticate posture is a symptom of a severe brain injury or condition, not a disease itself. Therefore, it is usually accompanied by other signs and symptoms that indicate the underlying cause and the extent of the brain damage. Some of these signs and symptoms are:
-
Loss of consciousness, awareness, or responsiveness.
-
Difficulty breathing, speaking, or swallowing.
-
Changes in heart rate, blood pressure, or temperature.
-
Seizures, spasms, or tremors.
-
Headache, nausea, vomiting, or drowsiness.
-
Vision, hearing, or speech problems.
-
Confusion, agitation, or hallucinations.
-
Memory, attention, or cognitive impairments.
-
Personality, mood, or behavioral changes.
How is decorticate posture diagnosed?
A doctor may also perform a neurological exam to assess a patient’s level of consciousness, reflexes, and brain function. Decorticate posture is diagnosed by observing the patient’s body position and response to stimuli or pain. A Glasgow Coma Scale (GCS) is a common tool that measures eye, verbal, and motor responses and assigns a score from 3 to 15. A lower score indicates a deeper coma and a worse prognosis.
To determine the cause and location of the brain damage, a doctor may also order some imaging tests, such as:
-
Computed tomography (CT) scan, which uses X-rays to create cross-sectional images of the brain and show any bleeding, swelling, or fractures.
-
Magnetic resonance imaging (MRI) scan, which uses magnets and radio waves to create detailed images of the brain and show any tumors, infections, or strokes.
-
Cerebral angiography, which uses a dye and X-rays to show the blood vessels in the brain and detect any blockages or ruptures.
How is decorticate posture treated?
Decorticate posture is a medical emergency that requires immediate treatment. The main goals of treatment are to stabilize the patient’s vital signs, reduce the pressure in the brain, and address the underlying cause of the brain damage. Some of the treatment options are:
-
Oxygen therapy, which delivers oxygen to the patient’s lungs and brain through a mask or a tube.
-
Intravenous fluids, which provide hydration and electrolytes to the patient’s body through a needle or a catheter.
-
Medications, which can include painkillers, anti-inflammatory drugs, antibiotics, anticonvulsants, or sedatives, depending on the patient’s condition and symptoms.
-
Surgery, which may be necessary to remove a brain tumor, drain excess fluid, stop bleeding, or relieve pressure in the skull.
-
Rehabilitation, which may involve physical, occupational, speech, or cognitive therapy to help the patient recover from the brain injury and regain some function and quality of life.
How can decorticate posture be prevented?
Decorticate posture is a result of a serious brain injury or condition that is often unpredictable and unavoidable. However, some of the risk factors that can increase the chances of developing decorticate posture are:
-
Head trauma, which can be prevented by wearing a helmet, seat belt, or protective gear when engaging in sports, driving, or working.
-
Stroke, which can be prevented by controlling high blood pressure, cholesterol, diabetes, and smoking, and seeking medical attention for any signs of a stroke, such as sudden weakness, numbness, or difficulty speaking.
-
Brain infection, which can be prevented by getting vaccinated, washing hands, avoiding contact with sick people, and seeking medical attention for any signs of infection, such as fever, headache, or stiff neck.
-
Drug overdose, poisoning, or liver failure, which can be prevented by avoiding or limiting the use of alcohol, drugs, or medications, and seeking medical attention for any signs of overdose, poisoning, or liver failure, such as confusion, drowsiness, or jaundice.
Conclusion
A decorticate posture is a type of abnormal posture that indicates a severe brain injury or condition. A decorticate posture requires immediate diagnosis and treatment. A patient's prognosis and recovery depends on the cause and extent of the brain damage as well as their age, health, and response to treatment. By avoiding or reducing the risk factors that can cause a brain injury or condition, decorticate posture can be prevented.
