"Man in the Barrel" Syndrome with Anterior Spinal Artery Infarct due to Vertebral Artery Dissection

J Stroke Cerebrovasc Dis. 2017 Mar;26(3):e41-e42. doi: 10.1016/j.jstrokecerebrovasdis.2016.12.016. Epub 2017 Jan 5.

Abstract

Background: Man in the barrel syndrome (MBS) is a condition of brachial diplegia initially described after a bilateral watershed cerebral infarct between the anterior and the middle cerebral artery territories.

Objective: To report a case of MBS as a consequence of anterior spinal artery infarct due to vertebral artery dissection.

Discussion: More recently, nonischemic lesions in brain and brain stem have also been described as etiologies of MBS. There are few reports describing spinal cord infarction leading to MBS. The anterior spinal artery syndrome with only brachial diplegia also represents a rare and atypical pattern.

Conclusion: The conventional neurological consideration that MBS provides a precise anatomical localization is now challenged. The finding of a brachial diplegia leads to the need to investigate the brain, the spinal cord, and the peripheral nervous system.

Keywords: Man in the barrel syndrome; anterior spinal artery infarct; brachial diplegia; incomplete spinal cord infarct; intracranial vertebral artery dissection.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Hematoma / diagnostic imaging
  • Hematoma / etiology
  • Humans
  • Infarction / diagnostic imaging
  • Infarction / etiology*
  • Magnetic Resonance Angiography
  • Magnetic Resonance Imaging
  • Male
  • Vertebral Artery / diagnostic imaging
  • Vertebral Artery / pathology*
  • Vertebral Artery Dissection / complications
  • Vertebral Artery Dissection / diagnostic imaging