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Author Spotlight: Minimally Invasive Relief for Occipital Neuralgia at the Nuchal Line

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Pneumocephalus causing oculomotor nerve palsy: A case report.

Mackenzie Eileen Goodrich¹, Adam M Wolberg², Samir Kashyap³

¹Department of Neurosurgery, Burrell College of Osteopathic Medicine, Las Cruces, New Mexico.

Surgical Neurology International

|October 23, 2020

Summary

Pneumocephalus, or intracranial air, can rarely cause third cranial nerve palsy after brain surgery. Treatment with drains and oxygen expedited the resolution of this rare complication.

Keywords:

Cranial nerve Oculomotor Pneumocephalus

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Area of Science:

Neurosurgery
Neurology

Background:

Pneumocephalus (intracranial air) is common after cranial procedures but usually asymptomatic.
Cranial nerve palsies are rare complications of pneumocephalus.
Isolated third cranial nerve (oculomotor nerve) palsy due to pneumocephalus is exceptionally rare.

Observation:

A 26-year-old male presented with unilateral oculomotor nerve palsy post-cerebrospinal fluid leak repair.
Computed tomography revealed significant pneumocephalus.
The patient was treated with an epidural drain, external ventricular drain (EVD), and high-flow oxygen.

Findings:

The pneumocephalus resolved following treatment.
The patient's oculomotor nerve palsy completely resolved.
This case highlights the potential for pneumocephalus to cause isolated third nerve deficits.

Implications:

Pneumocephalus can cause isolated third cranial nerve palsy in rare instances.
While spontaneous resolution is possible, interventions like epidural and EVD may accelerate recovery.
Prompt recognition and management of pneumocephalus are crucial for resolving associated neurological deficits.