Man-in-the-barrel syndrome-like symptoms due to cervical infarction caused by transient hypoperfusion in the ascending cervical artery

Man-in-the-barrel syndrome (MIBS) is characterized by weakness in the bilateral upper-extremity muscles with relatively preserved strength in the face and lower-extremity muscles. We present a case of MIBS-like symptoms due to spinal cord infarction caused by transient hypoperfusion in the left ascending cervical artery (ACA) secondary to Stanford type A acute aortic dissection. To identify the ACA as the responsible artery, ischemic change by MRI of the longus colli muscle, which is primarily supplied by the ACA, was effective.