A decerebrate posture occurs when the arms and legs are held straight out, the toes are pointed downward, and the head and neck are arched backward. In a person with severe brain damage, muscles are rigidly tightened and held rigidly. This type of posturing usually indicates severe brain damage.
Decerebrate posture can be caused by various conditions that affect the brainstem, the part of the brain that connects the brain to the spinal cord. Some of the possible causes are:
Traumatic brain injury (TBI), such as from a car accident, a fall, or a gunshot wound.
Stroke, which is a sudden interruption of blood flow to the brain.
Brain hemorrhage, which is bleeding in the brain due to a ruptured blood vessel or an aneurysm.
Brain tumor, especially one that affects the lower midbrain or the pons, the sections of the brainstem below the upper midbrain.
Infection, such as meningitis, encephalitis, or severe malaria, that causes inflammation or swelling of the brain or the membranes that cover the brain and spinal cord.
Increased intracranial pressure, which is a buildup of pressure inside the skull due to various reasons, such as hydrocephalus, brain edema, or a mass lesion.
Brain damage from lack of oxygen, which can occur due to cardiac arrest, drowning, suffocation, or carbon monoxide poisoning.
Reye's syndrome, which is a rare but serious condition that affects children and causes sudden brain damage and liver failure.
As a result of a severe disruption in brain function, decerebrate posture is a symptom of serious brain injury or disorder. It is not a voluntary or conscious action. Despite strong prompts or efforts to wake them, a person with decerebrate posture will always remain unconscious and in a coma, meaning they won't wake up or respond to anything.
A person with decerebrate posture can have the following characteristics:
Legs extended and rigid.
Toes pointed away from the body and turned slightly inward.
Arms tensed, rotated toward the center of the body so palms face away from the body's center, and held parallel against the sides of the body.
Wrists flexed away from the body.
Fingers curled.
Arched or stiff back.
There are several types of abnormal postures, including decerebrate posture, which is characterized by bent arms and extended legs. It can also alternate with decorticate posture. It is also possible to have decorticate postures on one side of the body and decerebrate postures on the other.
A person with decerebrate posture requires immediate medical attention as it indicates a life-threatening condition. The patient will be admitted to the intensive care unit (ICU) in the hospital. The healthcare providers will then examine the patient's brain and nervous system thoroughly, as well as obtain a complete medical history from family and friends.
Some of the tests that may be done to diagnose the cause of decerebrate posture are:
Blood and urine tests to check for blood counts, drugs, toxins, chemicals, and minerals in the body.
Cerebral angiography, which is a procedure that uses a dye and an X-ray to visualize the blood vessels in the brain.
Computed tomography (CT) or magnetic resonance imaging (MRI) of the head, which are imaging techniques that use X-rays or radio waves to create detailed pictures of the brain and its structures.
Electroencephalogram (EEG), which is a test that measures the electrical activity of the brain.
Intracranial pressure (ICP) monitoring, which is a procedure that uses a device to measure the pressure inside the skull.
Lumbar puncture, which is a procedure that involves inserting a needle into the lower back to collect cerebrospinal fluid (CSF), the fluid that surrounds the brain and spinal cord.
Depending on the underlying cause and the severity of the brain damage, decerebrate posture is treated with the aim of stabilizing the person's condition, preventing further damage, and supporting vital functions.
Some of the possible treatments are:
Breathing assistance and placement of a breathing tube, which may be needed if the person has difficulty breathing or is not breathing at all.
Medications, such as sedatives, painkillers, anti-inflammatory drugs, antibiotics, or anticonvulsants, which may be given to reduce pain, inflammation, infection, or seizures.
Surgery, which may be done to remove a brain tumor, stop a brain bleed, relieve the pressure in the skull, or repair a skull fracture.
Cooling therapy, which may be used to lower the body temperature and reduce the metabolic demand of the brain.
Rehabilitation, which may include physical, occupational, and speech therapy, to help the person recover from the brain injury and regain some of the lost functions.
Decerebrate posture is a serious and often fatal condition that cannot be prevented in all cases. However, some of the possible ways to reduce the risk of developing decerebrate posture are:
Wearing a seat belt and a helmet when driving or riding a vehicle or a bicycle.
Avoiding falls, especially in older adults and children.
Seeking medical attention for any signs of stroke, such as sudden weakness, numbness, confusion, vision problems, or speech difficulties.
Controlling the risk factors for stroke, such as high blood pressure, high cholesterol, diabetes, smoking, and obesity.
Getting vaccinated against infections that can affect the brain, such as meningitis, encephalitis, or malaria.
Avoiding the use of illicit drugs, alcohol, or other substances that can harm the brain.
Seeking help for any signs of mental health problems, such as depression, anxiety, or suicidal thoughts.
