[Reversible "man-in-the-barrel" syndrome caused by hypoxic-ischemic encephalopathy].
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.
Segura Bruna
N
N
Servicio de Neurología, Hospital del Mar, Barcelona. 94407@imas.imim.es
Munteis Olivas
E
E
Gálvez Ruiz
A
A
Pont Sunyer
C
C
Rodríguez Campello
A
A