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Decortication is a medical procedure involving the surgical removal of the surface layer, membrane, or fibrous cover of an organ.The procedure is usually performed when the lung is covered by a thick, inelastic pleural peel restricting lung expansion.
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. 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.
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.
Abnormal posturing is an involuntary flexion or extension of the arms and legs, indicating severe brain injury.It occurs when one set of muscles becomes incapacitated while the opposing set is not, and an external stimulus such as pain causes the working set of muscles to contract. [1]
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.
It is sometimes referred to as a "response", to allow for possible conscious cerebral influence of the action. However, hopping and placing reactions, long loop stretch reflexes are probably integrated by the cerebral cortex. Decorticate animals show absence of this reflex.
The fencing response is an unnatural position of the arms following a concussion.Immediately after moderate forces have been applied to the brainstem, the forearms are held flexed or extended (typically into the air) for a period lasting up to several seconds after the impact.
Brainstem damage above the red nucleus level may cause decorticate rigidity. Responding to a startling or painful stimulus, the arms flex and the legs extend. The cause is the red nucleus, via the rubrospinal tract, counteracting the extensor motorneuron's excitation from the lateral vestibulospinal and reticulospinal tracts.