240 Short Reports Eur Neurol 2000;43:240–242 Simultaneous Brachial Diplegia and Rotational Vertigo due to Combined Spinal Anterior and

Simultaneous ischemia of the vertebrobasilar and anterior spinal artery territory is rare. Cheshire et al. [1] did not find evidence of brainstem symptoms in any of their 44 patients with spinal cord infarction nor in the additionally reviewed 155 cases. However, in 1966 Boudin et al. [2] reported on 2 patients with combined brain-stem and spinal cord lesions who had vertebral-artery stenosis docu-mented by angiography, and recently Pullicino [3] described a patient with vertigo and bilateral distal upper limb amyotrophy. We report on an exceptional case of combined, simultaneous ischemia in the vertebrobasilar and anterior spinal artery territory. Case Report A 56-year-old woman without any risk factors for atherosclerosis developed an acute case of severe rotatory vertigo, double vision and initially complete paralysis of both arms accompanied by pain and hypesthesia in both arms. The arm weakness considerably improve