A 45-year-old guy is taken to the emergency room after suffering a severe head injury in a car accident. During transit, the patient experienced numerous generalized tonic-clonic seizures and was discovered to be unresponsive. In addition to alcohol and cocaine abuse, hypertension is listed among medical histories. Blood pressure is 170/96 mm Hg, the temperature is 36.7 C (98.1 F), the pulse is 50/min, and the respirations are 10/min. 98 percent of the patient is using mechanical breathing with 50% oxygen, according to pulse oximetry. The patient is found to be comatose, with rigidly extended upper and lower limbs and midpositioned, fixed pupils. In the picture below, a non-contrast CT scan of the head is seen. Damage to which of the following structures is the most likely explanation for this patient's abnormal posturing?

Question

A 45-year-old guy is taken to the emergency room after suffering a severe head injury in a car accident. During transit, the patient experienced numerous generalized tonic-clonic seizures and was discovered to be unresponsive. In addition to alcohol and cocaine abuse, hypertension is listed among medical histories. Blood pressure is 170/96 mm Hg, the temperature is 36.7 C (98.1 F), the pulse is 50/min, and the respirations are 10/min. 98 percent of the patient is using mechanical breathing with 50% oxygen, according to pulse oximetry. The patient is found to be comatose, with rigidly extended upper and lower limbs and midpositioned, fixed pupils. In the picture below, a non-contrast CT scan of the head is seen.  Damage to which of the following structures is the most likely explanation for this patient's abnormal posturing?

Quizplus · Accepted Answer

Eductional Objective: Due to the disruption of the descending motor pathways, brain herniation results in aberrant posture (eg, rubrospinal, vestibulospinal). Damage to structures above the red nucleus, such as the cerebral hemispheres and internal capsule, is frequently accompanied by decorticate (flexor) posture. Damage to the midbrain to the pons, for example, frequently causes decerebrate (extensor) posture.

A 45-Year-Old Guy Is Taken to the Emergency Room After