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Decorticate posture is an abnormal posturing in which a person is stiff with bent arms, clenched fists, and legs held out straight. The arms are bent in toward the body and the wrists and fingers are bent and held on the chest.

This type of posturing is a sign of severe damage in the brain. People who have this condition should get medical attention right away.

Decorticate posture is a sign of damage to the nerve pathway between the brain and spinal cord. Although it is serious, it is usually not as serious as decerebrate posture.

The posturing may occur on one or both sides of the body.

• Bleeding in the brain (intracranial hemorrhage)
• Brain tumor
• Head injury
• Increased intracranial pressure from any cause
• Stroke
• Worsening of brain function that occurs from liver damage, infections in the brain, and other causes

The conditions that cause decorticate posture need to be treated in a hospital right away.

The person will receive emergency treatment right away. This includes getting a breathing tube and breathing assistance. The person will likely be admitted to the hospital and placed in intensive care.

After the condition is stable, the health care provider will get a medical history from family members and a more detailed physical examination will be done. This will include a careful examination of the nervous system.

Medical history questions may include:

• When did this behavior start?
• Is there a pattern to the postures?
• Is it always the same type of posture?
• Is there any history of a head injury or drug use?
• What other symptoms occurred before or with the abnormal posturing?

Tests that may be done include:

• Blood and urine tests to check blood counts, screen for drugs and toxic substances, and measure body chemicals and minerals
• Cerebral angiography (a dye and x-ray study of blood vessels in the brain)
• EEG (brain wave testing) orintracranial pressure (ICP) monitoring
• Head MRI or CT scan

The outlook depends on the cause of the posturing. There may be injury or damage to the brain or nervous system, which can leave the person with long-term problems such as:

• Coma
• Inability to communicate
• Paralysis
• Seizures

Mayer SA. Head injury. In: Rowland LP, ed. Merritt's Neurology. 11th ed. Baltimore, Md: Lippincott Williams & Wilkins; 2005:chap 64.

Mayer SA, Badjatia N. Head injury. In: Wolfson AB, Hendey GW, Ling LJ, et al, eds. Harwood-Nuss' Clinical Practice of Emergency Medicine. 5th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2009:chap 70.