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Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...
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Related Experiment Video

Updated: May 6, 2026

Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
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Delayed pneumocephalus-induced cranial neuropathy.

Neena I Marupudi1, Monika Mittal, Sandeep Mittal

  • 1Department of Neurosurgery, Wayne State University, Detroit Medical Center, and Karmanos Cancer Institute, 4160 John R Street, Suite 930, Detroit, MI 48201, USA.

Case Reports in Medicine
|October 24, 2013
PubMed
Summary

Postsurgical pneumocephalus, or intracranial air after brain surgery, rarely causes nerve damage. This case highlights an unusual bilateral oculomotor nerve palsy due to pneumocephalus, which resolved spontaneously.

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Area of Science:

  • Neurosurgery
  • Neurology
  • Ophthalmology

Background:

  • Pneumocephalus is common after cranial surgery, usually asymptomatic.
  • Cranial neuropathies from postsurgical pneumocephalus are rare, with only three prior reports of isolated deficits.
  • This study addresses an exceedingly uncommon presentation of bilateral oculomotor nerve palsy.

Purpose of the Study:

  • To report a unique case of bilateral oculomotor nerve palsy caused by postoperative pneumocephalus.
  • To illustrate direct cranial nerve compression by intracranial air.
  • To document the natural resolution of this rare neurological deficit.

Main Methods:

  • Case report of a patient experiencing dysconjugate eye movements post-neurosurgery.
  • Clinical examination and imaging to diagnose pneumocephalus and oculomotor nerve palsy.
  • Observation of neurological recovery during conservative management.

Main Results:

  • The patient presented with bilateral oculomotor nerve palsy, leading to dysconjugate eye movements.
  • Diagnosis confirmed postoperative pneumocephalus compressing the oculomotor nerves in the interpeduncular cistern.
  • Neurological symptoms gradually resolved as intracranial air was reabsorbed.

Conclusions:

  • Postsurgical pneumocephalus can, in rare instances, cause significant cranial nerve palsies.
  • Bilateral oculomotor nerve palsy due to pneumocephalus is an exceedingly rare complication.
  • Conservative management with observation is effective, with recovery correlating to air reabsorption.