A 61-year-old man presented with orthostatic headaches and asymmetric sensorineural hearing loss (ASNHL) 8 years after cervical laminoplasty. Percussion of his cervical spine elicited Lhermitte sign. Brain MRI demonstrated trace intraventricular blood andmild superficial siderosis (figure 1); digital subtraction angiogram had normal results. CT myelogram revealed fractured hardware puncturing a...