Unexpected complication after lumbar disc surgery, peripheral facial paralysis due to pneumocephalus: A case report

Pneumocephalus, characterized by air in the cranial cavity, is a rare condition typically associated with surgical procedures but may also result from trauma, infection, or spontaneously. Cranial nerve palsies following pneumocephalus are seldom documented in the literature, and, in particular, facial nerve palsies due to pneumocephalus following lumbar spine surgery have not yet been reported.

A 47-year-old male patient underwent surgery due to a herniated disc. Isolated grade 4 facial palsy, according to the House-Brackmann scale, on the left side developed after surgery. Computed tomography revealed pneumocephalus in the basal cisterns. The patient was treated without any problems conservatively.

While most cases are due to intracranial surgery, pneumocephalus caused by spinal surgery is extremely rare. Pneumocephalus usually occurs without symptoms but can occasionally be accompanied by headaches and rarely leads to focal neurological or cranial nerve deficits. This case emphasizes the importance of considering pneumocephalus as a possible complication after spinal surgery and highlights its rare association with cranial nerve deficits.