A woman with malaria displaying decerebrate posturing, with arms extended at her sides. (Image from World Health Organization).

Abnormal posturing, which indicates severe brain injury, refers to an involuntary flexion or extension of the extremities. It occurs when one set of muscles becomes incapacitated and the other set is not, and an external stimulus such as pain causes the working set of muscles to contract (AllRefer.com, 2003). Since posturing is an important indicator of the amount of damage that has occurred to the brain, it is used by medical professionals to measure the severity of a coma with the Glasgow Coma Scale (for adults) and the Pediatric Glasgow Coma Scale (for infants). Two types of abnormal posturing are decorticate and decerebrate posturing, also called decorticate and decerebrate responses, respectively. Opisthotonos, in which the head and back are arched backward, is another form of abnormal posturing. The presence of posturing indicates a severe medical emergency requiring immediate medical attention. Red blood cell infected with Malaria, derived from mala aria (Italian: bad air) and formerly called ague or marsh fever in English, is an infectious disease which causes about 350-500 million infections with humans and approximately 1. ... Brain damage or brain injury is the destruction or degeneration of brain cells. ... In anatomy, Flexion is movement whereby bones or other objects are brought closer together. ... In metaphysics, extension is the property of taking up space; see Extension (metaphysics). ... Extremities is a play by William Mastrosimone that was first performed on Broadway in 1982. ... A top-down view of skeletal muscle Muscle is the contractile tissue of the body and is derived from the mesodermal layer of embryonic germ cells. ... The term stimulus (plural: stimuli) has several related meanings: In physiology, a stimulus is something external that elicits or influences a physiological or psychological activity or response. ... Pain is an unpleasant sensation which may be associated with actual or potential tissue damage and which may have physical and emotional components. ... This article is in need of attention from an expert on the subject. ... The Glasgow Coma Scale is a neurological scale used to assess level of consciousness after head trauma and, importantly, to help keep track of patients progress over a period of time. ... The Pediatric Glasgow Coma Scale (also known as Pediatric Glasgow Coma Score or simply PGCS) is the equivalent of the Glasgow Coma Scale used to assess the mental state of adult patients. ... The words Opisthotonos or opisthotonus stem from the Greek language, opistho for behind and tonos for tension. ... A medical emergency is an injury or illness that poses an immediate threat to a persons health or life which requires help from a doctor or hospital. ...

Causes

Posturing can be caused by conditions that lead to an increase in intracranial pressure and brain herniation. Such conditions include traumatic brain injury, stroke, intracranial hemorrhage, brain tumors, and encephalopathy (ADAM, 2005). Intracranial pressure, or ICP, is the pressure of the brain, Cerebrospinal fluid (CSF), and the brains blood supply within the intracranial space. ... Herniation, a deadly side effect of very high intracranial pressure, occurs when the brain shifts across structures within the skull. ... Traumatic brain injury (TBI), traumatic injuries to the brain, also called acquired brain injury, intracranial injury, or simply head injury, occurs when a sudden trauma causes damage to the brain. ... A stroke or cerebrovascular accident (CVA) occurs when the blood supply to a part of the brain is suddenly interrupted. ... This article needs cleanup. ... A brain tumor is any intracranial mass created by an abnormal and uncontrolled growth of cells either normally found in the brain itself: neurons, glial cells (astrocytes, oligodendrocytes, ependymal cells), lymphatic tissue, blood vessels), in the cranial nerves (myelin producing Schwann cells), in the brain envelopes (meninges), skull, pituitary and... Encephalopathy is a container term for various conditions affecting the brain. ...

Decorticate Posturing

Patients with decorticate, or flexor, posturing present with the arms flexed, or bent inward on the chest, the hands are clenched into fists, and the legs extended. Decorticate posturing indicates damage to the mesencephalic region, or the corticospinal tract, along which impulses travel from the brain to the spinal cord (AllRefer.com, 2003). While an ominous sign of severe brain damage, decorticate posturing is not as serious as decerebrate posturing. In biological anatomy, the mesencephalon (or midbrain) is the middle of three vesicles that arise from the neural tube that forms the brain of developing animals. ... The corticospinal or pyramidal tract is a massive collection of axons that travel between the cerebral cortex of the brain, and the spinal cord. ... The human brain. ... Cross-section through cervical spinal cord. ... Brain damage or brain injury is the destruction or degeneration of brain cells. ...

Decerebrate Posturing

In decerebrate, or extensor, posturing, the arms are extended by the sides, the head is arched back, and the legs are extended (ADAM, 2005). Decerebrate posturing indicates brain stem damage. A patient with decorticate posturing may begin to show decerebrate posturing, or may go from one form of posturing to the other (AllRefer.com). Posturing may occur on one or the other side of the body, or it may occur on both sides (AllRefer.com). The term brain stem (truncus encephali is a Latin synonym) refers to a composite substructure of the brain. ...

References

1. ADAM. 2005. "Decerebrate Posture".
2. AllRefer.com. 2003 “Decorticate Posture”. Available via the World Wide Web.
3. World Health Organization. 2005. Management of Severe Malaria: A Practical Handbook.
4. Yamamoto, Loren G. 1996. “Intracranial Hypertension and Brain Herniation Syndromes: Radiology Cases in Pediatric Emergency Medicine". Volume 5, Case 6. Kapiolani Medical Center for Women and Children; University of Hawaii; John A. Burns School of Medicine.