Man-in-the-barrel syndrome caused by cervical spinal cord infarction.

Acute brachial diplegia with normal findings of the legs, "man-in-the barrel" (MIB) syndrome, is generally thought to be caused by bilateral supratentorial brain lesions of the prerolandic cortical and subcortical area. We report 1 patient with a sudden onset of MIB syndrome with no supratentorial lesion but a hemodynamically induced atypical anterior spinal cord infarction after unilateral vertebral artery dissection. Thus, in MIB syndrome an infratentorial lesion site, including the cervical spinal cord, should also be considered.