title: "Man in the Barrel" Syndrome with Anterior Spinal Artery Infarct due to Vertebral Artery Dissection.
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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, SP, Brazil. Electronic address: carolrouanet@gmail.com.
authors.forename: Carolina
authors.initials: C
authors.lastname: Rouanet
authors.affiliation: Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Danyelle
authors.initials: D
authors.lastname: Reges
authors.affiliation: Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Eva
authors.initials: E
authors.lastname: Rocha
authors.affiliation: Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Vivian
authors.initials: V
authors.lastname: Gagliardi
authors.affiliation: Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Marcel Ken
authors.initials: MK
authors.lastname: Uehara
authors.affiliation: Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Maramelia Alves
authors.initials: MA
authors.lastname: Miranda
authors.affiliation: Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Gisele Sampaio
authors.initials: GS
authors.lastname: Silva
mesh_terms: D000328:Adult; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D007238:Infarction / Q000000981:diagnostic imaging / Q000209:etiology*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D020217:Vertebral Artery Dissection / Q000150:complications / Q000000981:diagnostic imaging
keywords: Man in the barrel syndrome; anterior spinal artery infarct; brachial diplegia; incomplete spinal cord infarct; intracranial vertebral artery dissection