Abnormal posturing

Abnormal body postures due to severe brain injury

Abnormal posturing refers to involuntary flexion or extension of the arms and legs, indicating severe brain injury. It is often observed in patients with conditions such as traumatic brain injury, stroke, or intracranial hemorrhage. Abnormal posturing is a critical sign in the Glasgow Coma Scale and can help in assessing the severity of brain damage.

Types of Abnormal Posturing

Abnormal posturing is generally categorized into two main types: decorticate posturing and decerebrate posturing.

Decorticate Posturing

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Illustration of decorticate posturing

Decorticate posturing, also known as flexor posturing, is characterized by:

• Flexion of the arms at the elbows
• Adduction of the arms
• Extension and internal rotation of the legs

This type of posturing indicates damage to the corticospinal tract above the level of the red nucleus, typically involving the cerebral hemispheres, internal capsule, or thalamus.

Decerebrate Posturing

Illustration of decerebrate posturing

Decerebrate posturing, also known as extensor posturing, is characterized by:

• Extension of the arms and legs
• Pronation of the arms
• Plantar flexion of the feet

This type of posturing suggests damage to the brainstem, specifically below the level of the red nucleus, affecting the midbrain or pons.

Clinical Significance

Abnormal posturing is a significant clinical sign that indicates severe brain injury. It is often used in conjunction with other clinical assessments to determine the level of consciousness and the extent of brain damage. The presence of decorticate or decerebrate posturing can influence the prognosis and management of patients with severe brain injuries.

Management

The management of patients exhibiting abnormal posturing involves addressing the underlying cause of the brain injury. This may include:

• Surgical intervention to relieve intracranial pressure
• Medical management to control cerebral edema
• Supportive care in an intensive care unit

Related pages

• Glasgow Coma Scale
• Traumatic brain injury
• Intracranial hemorrhage
• Cerebral edema

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  Decorticate posturing

• Decerebrate posturing