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

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.
(Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.)