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56 Possible Causes for Decorticate Posture, Fixed Pupils

  • Brain Stem Herniation

    Decorticate posturing (figure top) is recognized as bilateral flexion at the elbows and wrists, shoulder adduction and extension of the lower extremities occurring with lesions[casemed.case.edu] Hyperventilation or Cheyne-Stokes Absent (eyes fixed) Decerebrate posturing, or nothing Lower pons and medilla Both pupils fixed and unreactive Apnoea Absent (eyes fixed)[derangedphysiology.com] The disrupted brainstem can lead to decorticate posture, respiratory center depression and death.[en.wikipedia.org]

  • Traumatic Brain Injury

    Symptoms in severe traumatic brain injury include: Absent, diminished, or unbalanced pupil reaction Hemiparesis Decerebrate or decorticate posturing Bradypnea, apnea, or fixed[symptoma.com] posturing (abnormal flexion) Responds to pain with decorticate posturing (abnormal flexion) 3 Responds to pain with decerebrate posturing (abnormal extension) Responds to[merckmanuals.com] His mental status declined, first losing the ability to follow commands and rapidly becoming unresponsive with fixed and dilated pupils.[doi.org]

  • Brain Death

    Criteria for establishing brain death (BD) require absence of all brainstem-mediated reflexes including motor (ie, decerebrate or decorticate) posturing.[ncbi.nlm.nih.gov] A 28-year-old man was admitted following a road traffic accident with a Glasgow Coma Score (GCS) of 3/15 and fixed pupils.[ncbi.nlm.nih.gov] Components of a complete neurological examination are: Examination of the patient-absence of spontaneous movement, decerebrate or decorticate posturing, seizures, shivering[ncbi.nlm.nih.gov]

  • Intracranial Hemorrhage

    Initial emergency room evaluation found the patient to have anisocoria with a fixed and dilated right pupil and demonstrated evidence of decorticate posturing.[ncbi.nlm.nih.gov] The pupils are now fixed and dilated. Abnormal posturing is absent. A brain CT scan is ordered.[foamcast.org] For example, suspected cerebral herniation characterized by posturing and a fixed, dilated (blown) pupil may be a key indicator that hyperventilation should be considered.[emsworld.com]

  • Reye Syndrome

    […] and decerebrate posturing Seizures Flaccidity Fixed dilated pupils Respiratory arrest Focal neurologic findings usually are not present.[merckmanuals.com] Stage IV: Seizures are present and are accompanied by a deepening coma, decerebrate rigidity, loss of oculocephalic reflexes, and fixed pupils.[web.archive.org] There is decorticate (flexor) posturing with intact pupillary light reflexes.. .. ..[hawaii.edu]

  • Malaria

    Definition of decorticate, decerebrate and opisthotonic posturing Abnormal motor posturing, classified as decorticate, decerebrate or opisthotonic posturing is characterised[pubmedcentral.nih.gov] 12 (4.7) 1 (1.3) 0.32* 4 (6.6) 0.52* 2 (9.1) 0.31* Pupil sizes Constricted 42 (16.5) 6 (7.5) 0.05 5 (8.2) 0.10 3 (13.6) 1.00* Dilated 41 (16.2) 20 (25.0) 0.08 17 (27.9) 0.03[pubmedcentral.nih.gov] These were most marked with opisthotonic posturing and more pronounced with decerebrate than with decorticate posturing.[pubmedcentral.nih.gov]

  • Hyperventilation

    Only if active seizures, or signs of transtentorial herniation such as fixed or asymmetric pupils, neurologic posturing (decerebrate or decorticate), Cushing's reflex (hypertension[health.ny.gov] Only if active seizures, or signs of transtentorial herniation such as fixed or asymmetric pupils, neurologic posturing (decerebrate or decorticate), Cushing's reflex (hypertension[health.ny.gov]

  • Acute Hyperventilation

    Only if active seizures, or signs of transtentorial herniation such as fixed or asymmetric pupils, neurologic posturing (decerebrate or decorticate), Cushing's reflex (hypertension[health.ny.gov] Only if active seizures, or signs of transtentorial herniation such as fixed or asymmetric pupils, neurologic posturing (decerebrate or decorticate), Cushing's reflex (hypertension[health.ny.gov]

  • Metabolic Encephalopathy

    posturing. • Respiratory patterns, along with blood gas (acid-base balance) testing can narrow the differential diagnosis considerably.[medlink.com] […] results in mid- to large-sized sluggish or fixed pupils [ 2 ].[aneskey.com] Decorticate and decerebrate reflex posturings with noxious stimulation are commonly seen with progressive metabolic suppression of any type.[dartmouth.edu]

  • Hyponatremia

    A decorticate posturing indicates a lesion (a point of damage) at or above the red nucleus, whereas a decerebrate posturing indicates a lesion at or below the red nucleus.[en.wikipedia.org] Brainstem herniation - seen in severe acute hyponatraemia; signs include coma; fixed, unilateral, dilated pupil; decorticate or decerebrate posturing; respiratory arrest.[patient.info] In other words, a decorticate lesion is closer to the cortex, as opposed to a decerebrate posturing which indicates that the lesion is closer to the brainstem.[en.wikipedia.org]

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