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November 1968

Flexor Rigidity: Report in a Case of Pontine Tegmental Hemorrhage Due to Vascular Malformation

Author Affiliations

New York
From the Henry and Lucy Moses Research Laboratories of the Laboratory Division, Montefiore Hospital and Medical Center, New York (Dr. Hadfield); the departments of anatomy and neurology, College of Physicians and Surgeons, Columbia University, New York (Dr. Mettler); and the Division of Neurology, Montefiore Hospital and Medical Center, and the Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY (Dr. Sax). Dr. Hatfield is currently a Trainee in Neuropathology, NINDB, USPH at the Department of Pathology, Neuropathology Laboratory, and Department of Psychiatry and Neurology-Biochemistry Laboratory, New York University Medical Center, New York.

Arch Neurol. 1968;19(5):467-471. doi:10.1001/archneur.1968.00480050037003

FLEXOR postures following damage to nervous system have been well recognized and have been called flexion dystonia,1 pelvicrural flexion,2 flexor rigidity,3 or flexor quadriplegia. Previous clinical discussions have emphasized that this posture results following abnormality of spinal cord,4 following compression of brain stem,5 or following diffuse cerebral damage.6 We know of no reports in man that document such flexor postures following selective damage to the pontine tegmentum.

This report presents a case of flexor quadriplegia following destruction of pontine tegmentum by hemorrhage and will describe the anatomic areas which were damaged and document those tegmental structures whose absence results in release of this flexor posture in man. The findings in this case are in many ways comparable to the experimental results of Mettler,7,8 Bazett and Penfield," Thiele,10 Bard and Macht,11 and Denny-Brown.1

Report of a Case  This patient

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