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The unpredictable nature of penetrating SCI and complex systemic sequela contribute to the high mortality rates of penetrating SCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of case<\/jats:title>\n                    <jats:p>An 18-year-old-male patient was admitted to the emergency department with tetraparesis following a penetrating injury to the neck. Radiological examination revealed fractures of C4 and C5 spinous processes and extensive intradural pneumorrhachis. The patient was managed operatively with laminectomy, vertebral augmentation, and duroplasty. An acute decreased level of consciousness was observed four days after the operation. Laboratory investigation revealed critically low plasma sodium level. The patient remained decerebrated despite electrolyte correction and pronounced brain dead on the seventh postoperative day.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Metabolic derangements and pulmonary physiologic changes following trauma are lethal complications. Hyponatremic encephalopathy and disrupted pulmonary function caused by high cervical compression by the extensive pneumorrhachis contributes to the morality in this case report.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case report presents a rare clinical entity along with its\u2019 complications. Prompt clinical stabilization, strict biochemical monitoring, and multidisciplinary care from health care specialists are mandatory for SCI patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2020.02.063","type":"journal-article","created":{"date-parts":[[2020,3,3]],"date-time":"2020-03-03T13:22:36Z","timestamp":1583241756000},"page":"174-177","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Pneumorrhachis and hyponatremia after a neck hack\u2014A case report"],"prefix":"10.1097","volume":"68","author":[{"given":"Tommy","family":"Supit","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajid","family":"Risdianto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dody","family":"Priambada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhamad Thohar","family":"Arifin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Happy Kurnia","family":"Brotoarianto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-41-20260114","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1001\/archsurg.1993.01420170132021","article-title":"Incidence, characteristics, and outcome of spinal cord injury at trauma centers in North America","volume":"128","author":"Burney","year":"1993","journal-title":"Arch Surg"},{"key":"R2-41-20260114","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1007\/s00586-006-0160-6","article-title":"Pathogenesis, diagnosis and management of pneumorrhachis","volume":"15","author":"Oertel","year":"2006","journal-title":"Eur. 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