{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:43:57Z","timestamp":1787755437241,"version":"build-2784847793"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>Atlantoaxial instability (AAI) is a frequent complication of rheumatoid arthritis (RA), but its involvement in intracranial bleeding is unclear. We present a young woman with history of systemic lupus erythematosus and RA who developed 3 episodes of subdural bleeding at the upper cervical spine and cranial level. Imaging tests showed signs of AAI with odontoid deformity. The case was interpreted as recurrent traumatic cervical subdural hemorrhage because of AAI. No new episodes occurred after surgical C1-C2 fixation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We report a case that had the association of hemorrhage and C1-2 instability in a patient with RA and lupus erythematosus.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.21.00671","type":"journal-article","created":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T17:01:02Z","timestamp":1658422862000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Recurrent Cervical Subdural Bleeding Because of Atlantoaxial Instability in a Patient with Rheumatoid Arthritis"],"prefix":"10.2106","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0975-3052","authenticated-orcid":false,"given":"Diana","family":"Esteller Gauxax","sequence":"first","affiliation":[{"name":"Neurology Department, Hospital Clinic, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7074-2841","authenticated-orcid":false,"given":"Antonio","family":"Doncel-Moriano","sequence":"additional","affiliation":[{"name":"Neurology Department, Hospital Clinic, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3895-4067","authenticated-orcid":false,"given":"Jaime Jes\u00fas","family":"Mart\u00ednez-Anda","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery and Trauma Department, Hospital Clinic, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6085-492X","authenticated-orcid":false,"given":"Ricard","family":"Cervera","sequence":"additional","affiliation":[{"name":"Department of Autoimmune Diseases, Hospital Cl\u00ednic, Barcelona, Spain"},{"name":"Institut d'Investigaci\u00f3 Biom\u00e9dica August Pi i Sunyer (IDIBAPS), Barcelona, Spain"},{"name":"University of Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1464-2237","authenticated-orcid":false,"given":"Laura","family":"Llull","sequence":"additional","affiliation":[{"name":"Neurology Department, Hospital Clinic, Barcelona, Spain"},{"name":"University of Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"Combalia","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery and Trauma Department, Hospital Clinic, Barcelona, Spain"},{"name":"Institut d'Investigaci\u00f3 Biom\u00e9dica August Pi i Sunyer (IDIBAPS), Barcelona, Spain"},{"name":"University of Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,4]]},"reference":[{"issue":"4","key":"bib2-20240805","doi-asserted-by":"crossref","first-page":"1957","DOI":"10.1007\/s10143-020-01412-1","article-title":"Cervical spine manifestations of rheumatoid arthritis: a review","volume":"44","author":"Shlobin","year":"2021","journal-title":"Neurosurg Rev."},{"key":"bib3-20240805","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1055\/s-0035-1568998","article-title":"C1-C2 instability associated with periodontoid inflammatory tissue leading to subarachnoid hemorrhage: a case report and review of the literature","volume":"4","author":"Draghi","year":"2015","journal-title":"Indian J Neurosurg."},{"issue":"12","key":"bib4-20240805","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1016\/j.autrev.2014.08.014","article-title":"Cervical spine involvement in rheumatoid arthritis-a systematic 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