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Related Experiment Video

Updated: May 17, 2026

Efficiently Recording the Eye-Hand Coordination to Incoordination Spectrum

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Published on: March 21, 2019

Local(eyes)ing signs in sequential bihemispheric strokes.

Daniel R Gold¹, Karen M Aquino, Carolyn A Cronin

¹Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104, USA. daniel.gold@uphs.upenn.edu

The Neurologist

|November 2, 2012

Summary

Decerebrate posturing can indicate severe brain injury. This case shows it can also result from extensive forebrain lesions, especially with specific eye movements and coma.

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Area of Science:

Neurology
Neuroscience
Stroke Medicine

Background:

Decerebrate posturing is commonly associated with midbrain lesions.
Massive bilateral forebrain lesions can also manifest as decerebrate posturing.
Concurrent roving eye movements and intact brainstem reflexes suggest forebrain pathology.

Observation:

A patient presented with stroke symptoms, progressing to coma, decerebrate posturing, and alternating gaze preference with roving eye movements.
Electroencephalography revealed bihemispheric dysfunction.
Magnetic resonance imaging identified new infarcts in the right middle cerebral artery territory, including A1 and M1 occlusions.

Findings:

The patient's presentation of coma, specific eye movements, and decerebrate posturing indicated extensive forebrain injury.
Successful recanalization was achieved with intra-arterial tissue plasminogen activator.
The neuroanatomical and pathophysiological context supports the localization of these signs to bilateral forebrain lesions.

Implications:

This case underscores the diagnostic significance of combining specific neurological signs for accurate lesion localization.
Understanding the neuroanatomy of decerebrate posturing and eye movement patterns is crucial for diagnosing stroke complications.
The findings contribute to the clinical understanding of stroke-related neurological deficits and their underlying mechanisms.