Síndrome del ¿hombre en barril¿. A propósito de un caso / The man-in-the-barrel syndrome. A case report

ABSTRACT

The man-in-the-barrel syndrome (MIB) describes an uncommon clinical picture of bilateral proximal brachial paralysis with preserved mobility of the lower limbs and facial muscles, secondary to systemic arterial hypotension with hypoperfusion encephalic, bilateral ischemic strokes originating in territories bordering between the anterior and medial cerebral arteries, with very serious prognosis. It occurs after a cardiopulmonary arrest, hypovolemic shock, overdose of narcotics, hypotension after myocardial infarction or occlusion of the airway and accounts for 5 % to 12 % of the ischemic attacks. We present the case of a 27-year-old man, diagnosed with endocarditis by streptococcus with severe aortic insufficiency and arteritis of the pulmonary artery, with an intervention for aortic valve replacement and arterial cleaning. During post-intervention, motor focality consistent with MIB syndrome due to hypoxoischemic encephalopathy in the bihemispheric border territory was observed. We describe his evolution and treatment, stressing his good recovery on the contrary to that found in the literature (AU)