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Foramen magnum meningiomas: A report of 10 cases and review of literature
Abstract
Introduction
Foramen magnum meningiomas are uncommon skull basal meningiomas. Although there has been great development of the anatomical knowledge for this region, several controversies still exist regarding aspects of tumor location, rate of vertebral artery (VA) encasement, rate of tumor recurrence, and surgical approaches. We report a series of patients with foramen magnum meningioma treated in our institution.
Methods
We reviewed 10 consecutive cases of foramen magnum meningioma operated between January 2002 and December 2010 in the neurosurgery department of Avicenne Teaching Hospital.
Results
There were 6 female and 4 male patients (mean age 41.7 ± 6.4 years; range, 32-68 years). Foramen magnum meningiomas were classified as anterior (1 case), anterolateral (2 cases), and posterolateral (7 cases). Headache and dizziness (90%), and cervico-occipital pain (50%) were the most common presenting symptoms. Eight patients were operated on in the sitting position and 2 patients in the park-bench position due to the presence of a patent foramen ovale. The posterior midline approach was performed in 7 cases, far-lateral approach in 3 cases. Gross total resection was achieved in 70% of patients. Surgical mortality was 0 %.
Conclusion
Foramen magnum meningiomas are challenging tumors in the vicinity of the brainstem, the vertebral artery, and lower cranial nerves. Several surgical approaches are possible, each one with specific indication.
Keywords. Foramen magnum; meningioma; surgical approach
Foramen magnum meningiomas are uncommon skull basal meningiomas. Although there has been great development of the anatomical knowledge for this region, several controversies still exist regarding aspects of tumor location, rate of vertebral artery (VA) encasement, rate of tumor recurrence, and surgical approaches. We report a series of patients with foramen magnum meningioma treated in our institution.
Methods
We reviewed 10 consecutive cases of foramen magnum meningioma operated between January 2002 and December 2010 in the neurosurgery department of Avicenne Teaching Hospital.
Results
There were 6 female and 4 male patients (mean age 41.7 ± 6.4 years; range, 32-68 years). Foramen magnum meningiomas were classified as anterior (1 case), anterolateral (2 cases), and posterolateral (7 cases). Headache and dizziness (90%), and cervico-occipital pain (50%) were the most common presenting symptoms. Eight patients were operated on in the sitting position and 2 patients in the park-bench position due to the presence of a patent foramen ovale. The posterior midline approach was performed in 7 cases, far-lateral approach in 3 cases. Gross total resection was achieved in 70% of patients. Surgical mortality was 0 %.
Conclusion
Foramen magnum meningiomas are challenging tumors in the vicinity of the brainstem, the vertebral artery, and lower cranial nerves. Several surgical approaches are possible, each one with specific indication.
Keywords. Foramen magnum; meningioma; surgical approach
