Transient Man-in-a-Barrel Syndrome Secondary to Vertebral Artery Stenosis Case Report

Man-in-a-barrel syndrome (MIBS) is a neurologic condition characterized by bilateral upper extremity weakness, leaving the arms confined to the sides of the body, and typically results from cortical pathologies. We present an unusual case of MIBS where symptoms manifested because of anterior spinal artery hypoperfusion secondary to vertebral artery stenosis. This case challenges conventional MIBS causes and highlights the importance of considering cervical spinal cord hypoperfusion in the differential diagnosis. This case may help expand the understanding of MIBS, emphasizing a need for broader consideration, extending beyond cortical origins to include cervical spinal cord hypoperfusion.