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

October 2025 in “ Cureus ”

J. González Martín-Moro, Vicente Miralles Pechuán, F. Gómez Sanz, F. Aguilera del Hoyo, Maria Rosario Gómez de Liaño

A 47-year-old man developed right fourth nerve palsy five days after hair replacement surgery. MRI showed a mega-cisterna magna, and it is hypothesized that prolonged vertical posture post-surgery reduced pressure in this space, causing cerebrospinal fluid shifts and brainstem instability. The fourth cranial nerve's unique configuration makes it susceptible to such movements, potentially leading to the mild paresis observed.

View this study on cureus.com →

Discuss this study in the Community →

Research cited in this study

5 / 5 results

research Reducing Surgical Risks For Hair Replacement Surgery

February 2023 in “Facial Plastic Surgery Clinics of North America”

Careful planning and skilled surgery can make hair replacement safe and effective.

research Complications of Hair Transplant Procedures: Causes and Management

8 citations , October 2021 in “Indian Journal of Plastic Surgery/Indian journal of plastic surgery”

Hair transplants are mostly safe but can have minor complications.

research Complications with Hair Transplantation

12 citations , April 2020 in “Facial Plastic Surgery Clinics of North America”

Hair transplant complications are rare with good planning and technique, but risks include infection, bleeding, and patient dissatisfaction.

research Complications of Hair Restoration Surgery: A Retrospective Analysis

22 citations , October 2014 in “International Journal of Trichology”

Hair restoration surgery can lead to swelling, infections, scarring, numbness, hiccups, and poor hair growth.

research Complications in Hair Restoration Surgery

25 citations , January 2009 in “Oral and Maxillofacial Surgery Clinics of North America”

Successful hair transplant surgery depends on careful patient selection, proper surgical plan and technique, and attentive aftercare.