Cruciate paralysis is an uncommon injury to the cervicomedullary junct
ion. Five patients with injuries of the upper cervical spine and the c
linical manifestation of cruciate paralysis are presented. This injury
pattern is characterized by bilateral upper extremity paralysis, with
minimal or no lower extremity involvement. The neuroanatomic basis an
d the diagnosis of this clinical entity are discussed, and the related
reports in the literature are reviewed.