{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T10:33:33Z","timestamp":1773398013446,"version":"3.50.1"},"reference-count":12,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Pilocytic astrocytoma is a benign, slow-growing pediatric brain tumor, while Grisel\u2019s syndrome refers to nontraumatic atlantoaxial subluxation classically associated with infection or head-and-neck surgery. Postoperative atlantoaxial rotatory subluxation following intracranial surgery is rare and poses significant diagnostic and management challenges.<\/jats:p>\n <\/jats:sec>\n \n Case Description:<\/jats:title>\n We report a 7-year-old girl who presented with progressive headaches, imbalance, and signs of obstructive hydrocephalus. Imaging revealed a large cystic pilocytic astrocytoma involving the left frontotemporo-parietal region. The patient underwent left fronto-temporo-parietal craniotomy with excisional biopsy and placement of an Ommaya reservoir. Two weeks postoperatively, she developed painful neck spasm and mild torticollis. Cervical imaging confirmed C1\u2013C2 rotatory subluxation (Fielding Type II), likely related to surgical positioning, with Grisel\u2019s syndrome considered a possible inflammatory mechanism. Management included halo traction, closed reduction under general anesthesia, followed by halo vest immobilization and later application of a Miami-J cervical collar. The patient demonstrated good clinical and radiological recovery.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n This case highlights a rare postoperative complication of craniotomy with the development of atlantoaxial rotatory subluxation. Early recognition and multidisciplinary management are essential to prevent neurological sequelae. Surgical positioning may represent a contributing risk factor, and further research is required to establish preventive strategies.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_1274_2025","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T09:02:32Z","timestamp":1773392552000},"page":"148","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A case report of postoperative atlantoaxial rotatory subluxation following craniotomy for pilocytic astrocytoma in a pediatric patient"],"prefix":"10.25259","volume":"17","author":[{"given":"Yousef","family":"Bassi","sequence":"first","affiliation":[{"name":"Department of Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thamer H.","family":"Alsharif","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King Abdulaziz Specialist Hospital, Taif, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ziad E.","family":"Alzahrani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulrahman","family":"Alofi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King Abdulaziz Specialist Hospital, Taif, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danah Kamal","family":"Kabrah","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King Abdulaziz Specialist Hospital, Taif, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mashhour A.","family":"Alsuwat","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King Abdulaziz Specialist Hospital, Taif, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"10.25259\/SNI_1274_2025\/ref-1","first-page":"127","article-title":"No. LXIV. The Nervous System of the Human Body, Embracing Papers to the Royal Society on the Subject of Nerves","author":"Bell","year":"1830"},{"key":"10.25259\/SNI_1274_2025\/ref-2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2014\/703021","article-title":"Grisel\u2019s syndrome: A rare complication following adenotonsillectomy","volume":"2014","author":"Bucak","year":"2014","journal-title":"Case Rep Otolaryngol"},{"key":"10.25259\/SNI_1274_2025\/ref-3","doi-asserted-by":"crossref","first-page":"455","DOI":"10.3171\/jns.1988.69.3.0455","article-title":"Infection-related spontaneous atlantoaxial dislocation in an adult. Case report","volume":"69","author":"Clark","year":"1988","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_1274_2025\/ref-4","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1007\/s00405-010-1241-z","article-title":"\u201csmall\u201d operations and infections in the ENT region","volume":"267","author":"Deichmueller","year":"2010","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"10.25259\/SNI_1274_2025\/ref-5","doi-asserted-by":"crossref","first-page":"502","DOI":"10.25259\/SNI_805_2022","article-title":"Torticollis in an 8-year-old child due to Grisel\u2019s syndrome-a case report","volume":"13","author":"Ghodke","year":"2022","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_1274_2025\/ref-6","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1097\/SCS.0b013e31817ac55","article-title":"Grisel syndrome: Nontraumatic atlantoaxial rotatory subluxation","volume":"19","author":"Harma","year":"2008","journal-title":"J Craniofac Surg"},{"key":"10.25259\/SNI_1274_2025\/ref-7","doi-asserted-by":"crossref","first-page":"1823","DOI":"10.1016\/j.ijporl.2007.07.002","article-title":"Grisel\u2019s syndrome in otolaryngology: A systematic review","volume":"71","author":"Karkos","year":"2007","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"10.25259\/SNI_1274_2025\/ref-8","doi-asserted-by":"crossref","first-page":"1693","DOI":"10.1148\/rg.246045146","article-title":"From the archives of the AFIP: Pilocytic astrocytoma: Radiologic-pathologic correlation","volume":"24","author":"Koeller","year":"2004","journal-title":"Radiographics"},{"key":"10.25259\/SNI_1274_2025\/ref-9","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1093\/neuonc\/noab106","article-title":"The 2021 WHO classification of tumors of the central nervous system: A summary","volume":"23","author":"Louis","year":"2021","journal-title":"Neuro Oncol"},{"key":"10.25259\/SNI_1274_2025\/ref-10","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1007\/s00431-011-1493-7","article-title":"Eponym: Grisel syndrome","volume":"170","author":"Ortega-Evangelio","year":"2011","journal-title":"Eur J Pediatr"},{"key":"10.25259\/SNI_1274_2025\/ref-11","doi-asserted-by":"crossref","first-page":"E444","DOI":"10.1097\/01.brs.0000172226.35474.fe","article-title":"Successful reduction for a pediatric chronic atlantoaxial rotatory fixation (Grisel syndrome) with long-term halter traction: Case report","volume":"30","author":"Park","year":"2005","journal-title":"Spine (Phila Pa)"},{"key":"10.25259\/SNI_1274_2025\/ref-12","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1097\/00003086-198903000-00017","article-title":"Grisel\u2019s syndrome","volume":"240","author":"Wetzel","year":"1989","journal-title":"Clin Orthop Relat Res"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/a-case-report-of-postoperative-atlantoaxial-rotatory-subluxation-following-craniotomy-for-pilocytic-astrocytoma-in-a-pediatric-patient\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/a-case-report-of-postoperative-atlantoaxial-rotatory-subluxation-following-craniotomy-for-pilocytic-astrocytoma-in-a-pediatric-patient\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T09:02:34Z","timestamp":1773392554000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/a-case-report-of-postoperative-atlantoaxial-rotatory-subluxation-following-craniotomy-for-pilocytic-astrocytoma-in-a-pediatric-patient\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,13]]},"references-count":12,"alternative-id":["10.25259\/SNI_1274_2025"],"URL":"https:\/\/doi.org\/10.25259\/sni_1274_2025","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3,13]]},"article-number":"148"}}