Simultaneous brachial diplegia and rotational vertigo due to combined spinal anterior and vertebrobasilar embolism.

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 brainstem and spinal cord lesions who had vertebral-artery stenosis documented 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.