Evidence map›Paper›PMID 41328117›Full record

ArticleCureus2025

Fourth Nerve Palsy After Hair Replacement Surgery and Prolonged Vertical Position in a Patient With Mega-Cisterna-Magna: Report of a Case.

Julio González Martín-Moro, Vicente Miralles Pechuan, Fernando Gómez Sanz, Felipe Aguilera Del Hoyo, Maria Rosario Gómez de Liaño

Abstract readCase Reports
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Julio González Martín-MoroOphthalmology, Universidad Francisco de Vitoria, Madrid, ESP.
Vicente Miralles PechuanOphthalmology, Hospital Universitario del Henares, Madrid, ESP.
Fernando Gómez SanzOphthalmology, Hospital Universitario del Henares, Madrid, ESP.
Felipe Aguilera Del HoyoRadiodiagnosis, Hospital Universitario del Henares, Madrid, ESP.
Maria Rosario Gómez de LiañoOphthalmology, Hospital Universitario Clínico San Carlos, Madrid, ESP.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Hair replacement surgery is a common cosmetic procedure. We present the case of a healthy 47-year-old man who suffered a right fourth nerve palsy five days after surgery. Magnetic resonance imaging revealed the presence of a mega-cisterna magna. We hypothesize that in the presence of this anatomical variant, the reduction of pressure within this space, caused by prolonged vertical posture during the postoperative period, may have led to cerebrospinal fluid shifts causing brainstem anteroposterior instability. The special configuration of the fourth cranial nerve, which curves around the brainstem, and the fact that it is very thin and long, make it particularly vulnerable to anteroposterior movements of the brainstem. Therefore, we believe that small anteroposterior displacements of the brainstem could have stretched the nerve, inducing the mild paresis we report.

Indexed as

anatomical variantcerebrospinal fluidfourth nerve palsyhair transplantintracranial pressureisolated oculomotor nerve palsymega cisterna magnaoculomotor palsyprone positionspaceflight associated neuro-ocular syndrome

Identifiers

PMID41328117
PMCPMC12665333

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