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[Phase contrast MRI-based evaluation of cerebrospinal fluid circulation parameters in patients with foramen magnum
S V Kondrakhov1, N E Zakharova1, L M Fadeeva1
1Burdenko Neurosurgical Institute, Moscow, Russia.
Background:
Meningiomas of the foramen magnum (FMR) region account for 1.8 to 3.2% of all meningiomas. The international literature has insufficient data describing the state of cerebrospinal fluid (CSF) circulation in these patients.
Material And Methods:
We studied 38 patients with FM meningiomas, aged from 35 to 79 years (mean age, 56.7 years). The mean meningioma size was 30 mm (10-60 mm). Meningiomas had the anterolateral localization in 29 patients, ventral localization in 5 patients, and dorsal localization in 4 patients. Twenty nine patients underwent surgery. All operated patients were examined before and after surgery. The CSF circulation was studied using phase contrast MRI (PC-MRI).
Results:
The size and localization of FM meningiomas do not significantly affect the CFS circulation parameters. Pyramidal symptoms, sensory disorders, and XIth cranial nerve dysfunction are correlated with the CFS circulation parameters. According to the preoperative PC-MRI data, the CFS circulation parameters in all FM meningioma patients were significantly higher than their normal values. Surgery was followed by a reduction in the peak positive velocity, negative peak velocity, and range of the maximum linear velocity amplitude. Positive and negative volumes and the stroke volume did not change. Recovery dynamics of the CFS circulation parameters was similar, regardless of surgery completeness. According to the PC-MRI data, the CFS circulation parameters did not reach normal values in all groups of operated patients.
Conclusion:
The results of investigation of the CFS circulation in patients with FM meningiomas support the use of palliative surgery (partial resection, dural plasty, craniovertebral junction decompression) in the case of inoperable meningiomas.
Insights
Cerebrospinal fluid (CSF) circulation is altered in patients with foramen magnum meningiomas (FMR). Surgery reduces some CSF flow parameters, but they may not normalize, supporting palliative surgical options for inoperable tumors.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- Foramen magnum meningiomas (FMR) are rare, comprising 1.8-3.2% of all meningiomas.
- Limited international data exists on cerebrospinal fluid (CSF) circulation in FMR patients.
Purpose of the Study:
- To investigate CSF circulation in patients with foramen magnum meningiomas.
- To evaluate the impact of meningioma size, location, and surgical intervention on CSF dynamics.
Main Methods:
- Studied 38 patients with foramen magnum meningiomas (age 35-79).
- Assessed CSF circulation using phase contrast MRI (PC-MRI) before and after surgery in 29 operated patients.
- Correlated clinical symptoms with CSF circulation parameters.
Main Results:
- CSF circulation parameters were significantly elevated preoperatively in all FMR patients.
- Surgery reduced peak velocities and amplitude range, but not volumes.
- CSF circulation parameters did not normalize post-surgery in any patient group.
- Meningioma size and location did not significantly impact CSF circulation.
Conclusions:
- Altered CSF circulation is a key feature of foramen magnum meningiomas.
- Palliative surgical approaches are supported for inoperable meningiomas due to observed outcomes.
