title: Subarachnoid hemorrhage and acute hydrocephalus as a complication of C1 lateral mass screws.
abstract: METHODS
  Case report.
  
  
  OBJECTIVE
  To present a previously unreported complication of subarachnoid hemorrhage and hydrocephalus after C1 lateral mass screw insertion. To inform spine specialists of this potential postoperative complication.
  
  
  BACKGROUND
  Damage to the carotid artery, vertebral artery, hypoglossal nerve and dural tears are all recognized complications. Acute hydrocephalus as a result of subarachnoid hemorrhage is not previously reported.
  
  
  METHODS
  A 63-year-old female with a traumatic C1 ring and C2 peg fracture underwent C1-C2 fixation. During insertion of the C1 lateral mass screws there was significant hemorrhage from the C1-C2 venous plexus. Three days postoperatively, she developed headache, confusion, and became drowsy.
  
  
  RESULTS
  Computed tomographic scan of the brain revealed hydrocephalus and intraventricular blood that was managed with an external ventricular drain.
  
  
  CONCLUSIONS
  The case of acute hydrocephalus due to intraventricular hemorrhage from C1 lateral mass screw placement has not previously been reported. Surgeons performing the procedure should consider the diagnosis if patients display signs of raised intracranial pressure postoperatively.
  
  
  METHODS
  N/A.
authors.affiliation: From The Walton Centre for Neurology & Neurosurgery, Liverpool, UK. matthew.stovell@doctors.org.uk
authors.forename: Matthew George
authors.initials: MG
authors.lastname: Stovell
authors.forename: Robin
authors.initials: R
authors.lastname: Pillay
mesh_terms: D000208:Acute Disease; D001863:Bone Screws / Q000009:adverse effects*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000293:injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging* / Q000209:etiology; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000209:etiology; D011859:Radiography; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology