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Isolated man-in-the-barrel syndrome following cardiac surgery
1National Cardiac Surgical Unit, Mater Hospital Dublin, Ireland.
Insights
A hypertensive patient developed man-in-the-barrel syndrome after heart surgery. This rare neurological condition caused arm weakness, but the patient fully recovered with prompt medical attention.
Area of Science:
- Neurology
- Cardiovascular Surgery
Background:
- Coronary artery bypass graft (CABG) surgery is a major cardiovascular procedure.
- Chronic hypertension is a significant risk factor for cardiovascular events and complications.
Observation:
- A 59-year-old patient with chronic hypertension developed neurological deficits post-urgent CABG.
- The patient presented with "man-in-the-barrel syndrome," characterized by brachial diplegia (weakness in both arms) and preserved leg motor function.
Findings:
- Magnetic resonance imaging (MRI) revealed ischemic areas in the brain.
- These ischemic changes were consistent with hypoperfusion, leading to border-zone infarction between the anterior and middle cerebral artery territories.
Implications:
- Man-in-the-barrel syndrome can be a rare complication following cardiac surgery.
- Prompt diagnosis and management of hypoperfusion-related neurological deficits are crucial for patient recovery.
- This case highlights the importance of monitoring neurological function in patients undergoing major cardiovascular procedures.
Abstract:
A 59-year-old chronically hypertensive patient developed "man-in-the-barrel syndrome" following urgent coronary artery bypass graft surgery (CABG). This syndrome describes a brachial diplegia with intact motor function of the legs. Magnetic resonance imaging confirmed areas of ischaemia consistent with hypoperfusion leading to border-zone infarction between the territories of the anterior and middle cerebral arteries. The patient made a complete functional recovery.