What is decorticate posturing?

Decorticate posturing — a sign of severe damage to the brain — is a specific type of involuntary abnormal posturing of a person. Decorticate posture is stiff with legs held out straight, fists clenched, and arms bent to hold the hands on the chest.

Decorticate posturing is a type of abnormal or pathologic posturing, not to be mistaken with poor posture or slouching. Abnormal posturing is often an indication of certain types of injury to the brain or spinal cord. Types of posturing include:

  • decorticate posturing
  • decerebrate posturing, where arms and legs are straight and rigid, toes are pointed downward, and the head is arched backward
  • opisthotonic posturing, where the back is arched and rigid and the head is thrown backward
Decorticate Posturing

Causes of decorticate posturing

Decorticate posture can be caused by a number of conditions, including:

  • traumatic brain injury (TBI)
  • bleeding in the brain
  • brain tumor
  • stroke
  • brain problem due to drug use, poisoning, infection, or liver failure
  • increased pressure in the brain
  • infection, such as Reye’s syndrome, malaria, or encephalitis

When to see a doctor about decorticate posturing

Abnormal posturing is a condition that should be examined and treated right away by a doctor. A person with decorticate posturing will be unconscious, often in a coma. In many cases, the doctor will set up breathing assistance for the person and admit them into the hospital’s intensive care unit (ICU). A thorough examination of the brain and nervous system typically follows and may include some or all of the following:

  • CT scan or MRI of the head
  • EEG
  • cerebral angiography
  • lumbar puncture

What is the decorticate posturing prognosis?

The expected outcome depends on the cause. Decorticate posturing could indicate nervous system injury and permanent brain damage, which could result in:

  • seizures
  • paralysis
  • inability to communicate
  • coma

Outlook

Decorticate posturing is a sign of severe damage to the central nervous system, more specifically to the brain. If a family member or friend is involuntarily displaying this posturing, get them immediate medical attention at a hospital emergency room.

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