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Case Reports
. 2022 Apr 22;12(2).
doi: 10.2106/JBJS.CC.21.00671. eCollection 2022 Apr 1.

Recurrent Cervical Subdural Bleeding Because of Atlantoaxial Instability in a Patient with Rheumatoid Arthritis: A Case Report

Diana Esteller Gauxax  1 , Antonio Doncel-Moriano  1 , Jaime Jesús Martínez-Anda  2 , Ricard Cervera  3   4   5 , Laura Llull  1   5 , Andrés Combalia  2   4   5
Affiliations
Case Reports

Recurrent Cervical Subdural Bleeding Because of Atlantoaxial Instability in a Patient with Rheumatoid Arthritis: A Case Report

Diana Esteller Gauxax et al. JBJS Case Connect. .

Abstract

Case: 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.

Conclusion: We report a case that had the association of hemorrhage and C1-2 instability in a patient with RA and lupus erythematosus.

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Conflict of interest statement

Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/B830).

References

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    1. Draghi R, Giammattei L, Scarone P, Lanfranchi G, Bava A, Pluderi M. C1-C2 instability associated with periodontoid inflammatory tissue leading to subarachnoid hemorrhage: a case report and review of the literature. Indian J Neurosurg. 2015;4:180-4.
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