Cranial Settling Causing Intracranial Hemorrhage Through Violation of the Skull Base by Cervical Spine Instrumentation.
Publication/Presentation Date
1-1-2021
Abstract
BACKGROUND: Rheumatoid arthritis (RA) is a chronic inflammatory polyarthropathy that affects many synovial joints favoring the hands, knees, and vertebral articulations. Joint laxity manifests as subaxial instability, atlantoaxial instability, and cranial settling (CS).
CASE DESCRIPTION: A 70-year-old woman with past medical history of RA, Hashimoto's thyroiditis, osteoporosis, history of C1-2 fusion for instability 15 years prior, with subsequent revision cervicothoracic fusion for degeneration, and trauma 2 years prior presents with new onset headache, nausea, and vomiting of 36-hour duration. Neurologic examination was only notable for mild right dysmetria. Workup revealed acute hemorrhage in the posterior fossa with migration of the right rod implant and screw tulip, as a result of CS. The patient underwent occipital-cervical fusion with removal of the migratory hardware.
CONCLUSIONS: Intracranial rod migration and hemorrhage secondary to CS is a rare complication that must be brought to the attention of surgeons operating on patients with RA.
Volume
145
First Page
178
Last Page
182
ISSN
1878-8769
Published In/Presented At
Mahtabfar, A., Mazza, J., Franco, D., Gonzalez, G. A., Hines, K., Chalouhi, N., Jabbour, P., Harrop, J., & Heller, J. (2021). Cranial Settling Causing Intracranial Hemorrhage Through Violation of the Skull Base by Cervical Spine Instrumentation. World neurosurgery, 145, 178–182. https://doi.org/10.1016/j.wneu.2020.08.193
Disciplines
Medicine and Health Sciences
PubMedID
32890852
Department(s)
Department of Surgery
Document Type
Article