title: [Reversible "man-in-the-barrel" syndrome caused by hypoxic-ischemic encephalopathy].
abstract: BACKGROUND
  Hypoxic-ischemic encephalopathy can lead to different clinical presentations, such as bilateral cortical borderzone infarctions due to cerebral hypoperfusion (especially after cardiopulmonary arrest), which would cause a "man-in-the-barrel" syndrome if the anterior circulation is affected. This syndrome has multiple etiologies, both central (bilateral frontal and/or pyramidal decussation lesions and cervical spinal cord lesions) as well as peripheral ones such as multifocal motor neuropathy.
  
  
  METHODS
  We report the case of a 19-year-old man who developed a "man-in-the-barrel" syndrome with bilateral and proximal upper limb brachial diplegia after bilateral watershed infarctions involving distal fields of the middle and the anterior cerebral artery due to cerebral hypoperfusion in a comatose patient without internal carotid obstruction.
  
  
  CONCLUSIONS
  The rate of death in this syndrome is higher than 90% and it predicts a worse outcome in comatose patients. Nevertheless, our patient has had complete clinical improvement.
authors.affiliation: Servicio de Neurología, Hospital del Mar, Barcelona. 94407@imas.imim.es
authors.forename: N
authors.initials: N
authors.lastname: Segura Bruna
authors.forename: E
authors.initials: E
authors.lastname: Munteis Olivas
authors.forename: A
authors.initials: A
authors.lastname: Gálvez Ruiz
authors.forename: C
authors.initials: C
authors.lastname: Pont Sunyer
authors.forename: A
authors.initials: A
authors.lastname: Rodríguez Campello