رجل عمره ٦٠ سنة في العناية بعد نزيف دماغي كبير، فاقد الوعي، ومقياس غلاسكو ٥. عند المنبه المؤلم يفرد ذراعيه ويدير كفيه للخارج ويمد رجليه. ما هذه الوضعية ودلالتها؟

A 60-year-old man in ICU after a large brain haemorrhage is unconscious with GCS 5. To a painful stimulus he extends his arms, rotates his palms outward and extends his legs. What is this posture and its significance?

1. Decerebrate posturing, indicating brainstem injury
2. A normal pain response in an unconscious person
3. A focal seizure needing an antiepileptic only
4. Decorticate posturing, which is less serious

Answer: A) Decerebrate posturing, indicating brainstem injury. Extensor (decerebrate) posturing indicates deeper brainstem injury and a worse prognosis than flexor (decorticate) posturing with arms flexed onto the chest.