{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T06:37:47Z","timestamp":1779259067006,"version":"3.51.4"},"reference-count":44,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"13","license":[{"start":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T00:00:00Z","timestamp":1632700800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9,27]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Atlantoaxial sublaminar wiring has many known complications related to hardware failure, but intracranial hemorrhage is a rare complication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 61-year-old female patient with prior atlantoaxial sublaminar wiring for odontoid fracture nonunion experienced decreased level of consciousness due to a subarachnoid and subdural hemorrhage of the posterior fossa with intraventricular extension and hydrocephalus. Rupture of the sublaminar wire with intramedullary protrusion was the cause of the hemorrhage. The patient was treated with ventriculostomy for hydrocephalus and occipital cervical fusion for spinal instability, along with removal of the broken wire and drainage of a hematoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>This uncommon cause of intracranial hemorrhage highlights an additional risk of atlantoaxial sublaminar wiring compared with other atlantoaxial fusion techniques. In addition, this case suggests cervical instrumentation failure as a differential diagnosis of subarachnoid and subdural hemorrhage of the posterior fossa when a history of prior instrumentation is known.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case21211","type":"journal-article","created":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T03:35:39Z","timestamp":1632713739000},"source":"Crossref","is-referenced-by-count":1,"title":["Atlantoaxial wiring hardware failure resulting in intracranial hemorrhage and hydrocephalus: illustrative case"],"prefix":"10.3171","volume":"2","author":[{"given":"Anass","family":"Benomar","sequence":"first","affiliation":[{"name":"Department of Radiology, Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harrison J.","family":"Westwick","sequence":"additional","affiliation":[{"name":"Service of Neurosurgery, H\u00f4pital du Sacr\u00e9-C\u0153ur de Montr\u00e9al, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sami","family":"Obaid","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, Montreal, Quebec, Canada; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9","family":"Nzokou","sequence":"additional","affiliation":[{"name":"Service of Neurosurgery, H\u00f4pital Maisonneuve-Rosemont, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung-Joo","family":"Yuh","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, Montreal, Quebec, Canada; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Shedid","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, Montreal, Quebec, Canada; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"279","DOI":"10.2106\/00004623-197860030-00001","article-title":"Atlanto-axial arthrodesis by the wedge compression method","volume":"60","author":"Brooks AL","year":"1978","unstructured":"Brooks AL, Jenkins EB. 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