POSTURING [ back to Glossary Index ]
Posturing is the bodily manifestation of traumatic or stroke damage to the sub-cortical areas of the brain which control muscle tone. Decorticate posturing involves inward flexion of the elbows with fists coming together over the chest, and results from damage to the internal capsule, cerebral peduncles, basal ganglia or thalamus. Decerebrate posturing involves outward extension of all four extremities with arms at the sides and palms tucked under facing back towards the head. Decerebrate posturing indicates more severe neurologic injury and results from damage to the mid to upper brainstem. Postural abnormalities is a source of great concern following a severe TBI, because traction on the jugular vein can increase intra-cranial pressure leading to secondary brain damage. Acute patients in coma with high intra-cranial pressure must be positioned in bed so as to relieve pressure on the jugular vein, and eliminate that as one source of increased ICP.