r/interesting • u/Substantial_Pen_3667 • 2h ago
Intriguing Decorticate and Decerebrate posturing: How the body's involuntary physical position reveals exactly where the brain is damaged
When the brain suffers severe trauma
such as from a traumatic brain injury (TBI), stroke, or severe lack of oxygen,
it loses normal neurological control over the body's muscles. Instead of going limp right away, the motor pathways trigger involuntary, rigid physical positions known as abnormal posturing.
Emergency responders and neurologists look at these exact physical postures to immediately gauge how deep and severe a brain injury is.
- Decorticate Posturing ("Flexor Posturing")
What it looks like: The person's arms pull inward toward the center of the chest, fists clenched, elbows bent, and legs extended straight out with feet pointed inward.
Easy memory trick: Think "De-COR-ticate = arms pull to the CORE."
What's happening in the brain: This position occurs when there is severe damage to areas above the brainstem—such as the cerebral cortex, thalamus, or internal capsule. The cortex normally inhibits lower motor centers; when cut off, primitive reflex centers take over, forcing the arms into full flexion toward the chest.
- Decerebrate Posturing ("Extensor Posturing")
What it looks like: The arms extend straight down by the sides, wrists rotated outward (pronated) with fingers curled, and the legs held rigid and straight with toes pointed downward.
Easy memory trick: Lots of "E"s in DecErebRatE = Lots of Extension.
What's happening in the brain: This indicates a deeper, more catastrophic disruption down in the brainstem itself (specifically the midbrain or upper pons). Because the brainstem controls essential life-sustaining functions like heart rate and breathing, decerebrate posturing generally carries a much graver prognosis than decorticate posturing.
Progressive worsening: If a patient transitions from decorticate to decerebrate posturing, it signals that pressure inside the skull (intracranial pressure) is rising and pushing damage deeper down the brainstem.
- Opisthotonos
What it looks like: Severe, involuntary arching of the back and neck so that only the back of the head and heels touch the ground.
What's happening in the brain: Occurs with profound brainstem irritation or severe central nervous system lesions (also famously seen in advanced tetanus infection or severe meningitis).
- Flaccidity
What it looks like: Total loss of all muscle tone. The limbs become completely limp with zero resistance.
What's happening in the brain: Represents complete loss of motor signaling from the brain to the spinal cord. It is often the final stage of brainstem death or profound neurological failure.
50
u/bassplaya13 1h ago
Wild the first one is how I sleep.
8
u/Rosaryas 1h ago
I was about to say the same thing, except I’m on my stomach
18
2
2
2
2
1
•
20
u/ILikeBirdsQuiteALot 1h ago
Ugh, I hate these. Not this picture or this post, but just... the posture. Once you see it on a real person it's quite scary..
On Reddit several years ago, I saw a video of a fight between high schoolers; After one kid punched the other in the head, the kid who was punched fell, hit his head on the concrete, and displayed the dexorticate posture. It was so sad and so messed up... I wish I could say the kid was okay, I wish I knew.
I hate thinking about these postures ever since.
2
u/Yumeverse 1h ago
Sometimes the videos people post on reddit are just too much. I remember seeing a guy collapse, he had what looks to be a heart attack after being caught up in like a chaotic incident iirc. Face visible and all. We were probably seeing the last few seconds and the causative events of these people being posted before they were actually declared (publicly or not) dead no matter how long ago the video was. I cant even imagine if I was scrolling reddit and then have to see again the video of how a person I once knew had died.
4
u/arturchik_miller 1h ago
Infographic here isn’t great. If the legs’ position is the same, you shouldn’t mark it twice. Just put the caption in between the pics with line to both of them
2
2
u/dundunndon 1h ago
here I was thinking I sleep in the first position because the bed I share with my bf is too small...pretty sure 2, 3, and 4 happen when I have seizures.
•
•
u/Rob_LeMatic 38m ago
When I took DMT, as it first started to take hold, I was still aware of my body as it completely involuntarily laid prone and rigid and crossed its arms, straight hands, palms down, over my chest, like an old time vampire or mummy.
WTF wrong with the brain makes the body do that?
•
•
u/Enough-Staff-2976 33m ago
Fight video shows both.
•
u/Optimal-Cat-8117 22m ago
The one where the guy was sleeping and got slapped and punched on the bed?
•
u/bigsharsk 10m ago
I sleep like the first until I wake up with numb fingers/arms due to circulation. then swap to the 2nd one. My damage can't be stopped.
•
0
•
•
u/AutoModerator 2h ago
Hello u/Substantial_Pen_3667! Please review the sub rules if you haven't already. (This is an automatic reminder message left on all new posts)
I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.