CEREBRATE RIGIDITY (Latin de-prefix extraction, destruction + cerebrum brain; lat. rigidus is benumbed, nonflexible) — the sharp increase in a muscle tone leading to extension or bending of extremities, necks, spins.
For the first time D. of river is studied in Ch. Sherrington experiment in 1896 at section of a brainstem below red kernels and areas of vestibular nuclei are higher (see. Decerebration ).
At the person D. of river it is described by R. Magnus and Klein (R. Magnus, And. Kleijn, 1912), Turner (V. Turner, 1916), Wilson (S. A. Wilson, 1920), Walsh (F. M of R. Walshe, from 1922 to 1925), S. N. Davidenkov (1924, 1944), D. S. A footer (1947), L. M. Popova (1970), etc.
D. the river arises at defeat of a roof of a mesencephalon (a prelum her tumor, abscess, a hematoma), as well as at more extensive damages of a brain: at defeat of vessels of a brain of various etiology, tubercular meningitis, encephalitis, injuries, dropsy of a brain, toxemic encephalopathies, in particular at a renal coma, at hypoxemic states. Especially heavy frustration of a muscle tone are noted at a combination of defeat of mezentsefalopontinny department of a brain to defeat of bark of hemicerebrums and a cerebellum.
Studying of the mechanism D. of river is complicated because of bystry death of patients and lack of the expressed destructive changes in nervous tissue revealed gistol, methods. L. M. Popova (1970) described results gistol, researches of a brain of the child from the river expressed to D., life to Krom of 8,5 months was kept by methods of respiratory resuscitation. At a research of a brain of the dead the massive necrosis of bark of hemicerebrums, a cerebellum, the ways conducting from a thalamus to a red kernel and from it to a gear kernel was revealed. Kernels of a brainstem, a reticular formation were not struck. Apparently, D. of river results from a disinhibition of the trunk structures located below red kernels.
Increase in a muscle tone at D. of river at the person is shown by extensive or flexion and extensive muscle tension of extremities, a muscle tension of a neck, back. At extensive rigidity of a hand pronirovana are unbent and as much as possible, legs are extended and given, and feet are turned inside. The bent hands and the unbent legs are characteristic of flexion and extensive rigidity; less often hands are extended, and legs are bent. Various options of distribution of rigidity are described.
Of river can develop sharply, is more rare gradually (then in the course of formation of its manifestation change) and to have passing character in the form of attacks attacks (attacks of decerebration).
Oculomotor frustration with the expressed tonic cervical reflexes, with the advent of placing reaction, increase in tendon jerks, emergence sucking, prehensile and others patol, reflexes are possible. At some patients trembling is observed, horeomioklonichesky twitchings, the torsion spasm are slightly more rare. In process of increase in a muscle tone trembling and hyperkinesias disappear. Sometimes patients are uneasy, cry, groan. Consciousness is usually lost in whole or in part. At the kept or partially switched off consciousness patients are indifferent, nekontaktna, are absent emotional reactions. The respiratory rhythm is quite often broken or there is its stop in a phase of an inspiration that is considered by nek-ry authors as a peculiar manifestation of D. of river. It is necessary to distinguish D. of river from opisthotonos (see).
Treatment depends on the nature of basic process.
Of river is predictively an adverse sign and indicates heavy, usually irreversible nature of organic process in a trunk of a brain.
Bibliography: I. S berets. General physiology of a muscular and nervous system, t. 2, page 304, M. — L., 1948; Davidenkov G. H. A cerebrate rigidity in semiotics of a fire injury of a brain, Vopr, neyrokhir., No. 6, page 17, 1944; Popova L. M. The Kliniko-morfologichesky analysis of the cerebrate rigidity which arose in the conditions of resuscitation, Zhurn, a neuropath, and psikhiat., t. 70, No. 12, page 1776, 1970; F at t of e r D. S. A cerebrate rigidity at the person, Sverdlovsk, 1947, bibliogr.; In a z e t t H. G. a. P e n f i e 1 d W. G. A study of Sherrington decerebrate animal in chronic as well as acute condition, Brain, v. 45, p. 185, 1922; Juneja J. YovicA. Hepatic decerebration, Neurology (Minneap.), v. 22, p. 537, 1972, bibliogr.; Sherrington G. S. Decerebrate rigidity and reflex coordination of movement, J. Physiol. (Lond.), v. 22, p. 319, 1898; Wilson S. A. On decerebrate in man and the occurence of tonic fits, Brain, v. 43, p. 220, 1920.
H. H. Anosov.