A systematic review and meta-analysis on abnormal posturing among brain injury patients

Abstract

Background Abnormal motor posturing (AMP), exhibiting as decorticate, decerebrate, or opisthotonos, is regularly noticed among children and adults.

Objective This systematic review and meta-analysis examined the risk factors and outcome of posturing among severe head and brain injury subjects.

Methods Based on the inclusion and exclusion criteria and using MeSH terms: “decerebrate posturing”, “opisthotonic posturing”, “brain injury”, and/or “cerebral injury” articles were searched on Scopus, PubMed, Science Direct, and google scholar databases. Observational studies, case series, and case reports were included.

Results A total of 1953 studies were retrieved initially, and based on the selection criteria, 20 studies were finally selected for review and were analyzed for meta-analysis based on the mortality between the hematomas. The functional outcomes of this study are the risk factors, mortality rate and Glasgow Outcome Scale. Decerebrative patients were higher among the studies related to head injury surgeries. Males were mainly treated for decerebrate postures compared with the female subjects. Extradural hematoma and acute subdural hematoma with cerebral contusion were quite common in the surgical mass lesions.

Conclusion The findings reported that the lesion types, the operative procedures, and the age of the decerebrating patients with brain injuries are the significant prognostic factors determining the survival outcomes.

Resumo

Antecedentes Postura motora anormal (AMP), exibindo-se como decorticada, descerebrada ou opistótono, é regularmente observada entre crianças e adultos.

Objetivo Esta revisão sistemática e metanálise examinou os fatores de risco e os resultados da postura entre indivíduos com lesões graves na cabeça e no cérebro.

Métodos Com base nos critérios de inclusão e exclusão e usando termos MeSH: artigos sobre “postura descerebrada”, “postura opistótona”, “lesão cerebral” e/ou “lesão cerebral” foram pesquisados nas bases de dados Scopus, PubMed, Science Direct e Google Scholar. Foram incluídos estudos observacionais, séries de casos e relatos de casos.

Resultados Um total de 1.953 estudos foram recuperados inicialmente e, com base nos critérios de seleção, 20 estudos foram finalmente selecionados para revisão e analisados para metanálise com base na mortalidade entre os hematomas. Os resultados funcionais deste estudo são os fatores de risco, taxa de mortalidade e Escala de Resultados de Glasgow. Os pacientes descerebrados foram maiores entre os estudos relacionados a cirurgias de traumatismo cranioencefálico. Os homens foram tratados principalmente para posturas descerebradas em comparação com as mulheres. Hematoma extradural e hematoma subdural agudo com contusão cerebral foram bastante comuns nas lesões de massa cirúrgica.

Conclusão Os achados relataram que os tipos de lesões, os procedimentos operatórios e a idade dos pacientes descerebrados com lesões cerebrais são os fatores prognósticos significativos que determinam os resultados de sobrevivência.

Keywords

Decerebrate State - Brain Injuries - Systematic Review - Brain Injuries

Palavras-chave

Estado de Descerebração - Lesões Encefálicas - Revisão Sistemática - Lesões Encefálicas

Authors' Contributions

YW: conceptualization, project administration; YC, XP: data curation, formal analysis, methodology, software; WW: supervision, validation; YW, WW: writing – original draft. YW, YC: contributed equally to the article. All authors have read the manuscript and approved.

Publikationsverlauf

Eingereicht: 19. Januar 2024

Angenommen: 17. Februar 2024

Artikel online veröffentlicht:
23. April 2024

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