Decorticate posture

Definition
Decorticate posture is an abnormal posturing indicated by rigidity, flexion of the arms, clenched fists, and extended legs. The arms are bent inward toward the body with the wrists and fingers bent and held on the chest. Presence of this type of posturing implies severe damage to the brain with immediate need for medical attention.

Considerations
Decorticate posture indicates damage to the corticospinal tract (the pathway between the brain and spinal cord). Although a serious sign, it is usually more favorable than decerebrate posture.

Decorticate posture may progress to decerebrate posture, or the two may alternate. The posturing may occur on one or both sides of the body.

Common Causes

• Brain abscess
  
• Primary brain tumor
  
• Secondary brain tumor
  
• Increased intracranial pressure from any cause
  
• Stroke
  
• Head injury

Home Care
Conditions associated with decorticate posture require immediate hospital treatment.

Call your health care provider if
Abnormal posturing usually accompanies reduced consciousness. Anyone exhibiting an abnormal posture should be examined promptly by a health care provider.

Note: In some conditions such as prolonged coma, these behaviors can persist for an extended period of time.

What to expect at your health care provider’s office
Emergency measures may begin immediately, including placement of an artificial airway (breathing tube) and assistance with breathing. The person will likely be hospitalized and in intensive care.

After the condition is stabilized, the medical history will be obtained from family members and a physical examination will be performed.

Medical history questions documenting decorticate posture in detail may include:

• Time pattern
  o When did this behavior start?
  o Is there a pattern to the occurrences?
  
• Quality
  o Is it always the same type of posture?
  
• Other
  o Is there any significant medical history (such as a known Head injury)?
  o What other symptoms preceded or accompanied the abnormal posturing?

Physical examination will include a detailed assessment of the nervous system.

Diagnostic testing may include:

• Head MRI or CT scan
  
• Cerebral angiography
  
• EEG
  
• ICP monitoring

After seeing your health care provider, you may want to add a diagnosis related to decorticate posturing to your personal medical record.

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