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It is exhibited by people with lesions or compression in the midbrain and lesions in the cerebellum. [7] Decerebrate posturing is commonly seen in pontine strokes. A patient with decorticate posturing may begin to show decerebrate posturing, or may go from one form of posturing to the other. [1]
In humans, true decerebrate rigidity is rare since the damage to the brain centers it might be caused by usually are lethal. However, decorticate rigidity can be caused by bleeding in the internal capsule which causes damage to upper motor neurons. The symptoms of decorticate rigidity are flexion in the upper limbs and extension in the lower limbs.
Decorticate posturing, with elbows, wrists and fingers flexed, and legs extended and rotated inward. Brain herniation frequently presents with abnormal posturing, [2] a characteristic positioning of the limbs indicative of severe brain damage. These patients have a lowered level of consciousness, with Glasgow Coma Scores of three to five.
Decorticate posturing, indicating a lesion at the red nucleus or above. This positioning is stereotypical for upper brain stem, or cortical damage. The other variant is decerebrate posturing, not seen in this picture. Assessment of posture and physique is the next step. It involves general observation about the patient's positioning.
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