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Foramen magnum meningiomas
Shyamal C Bir1, Tanmoy K Maiti1, Anil Nanda2
1Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, LA, United States.
Abstract:
The foramen magnum meningioma (FMM) is one of most challenging tumors among all the meningiomas because of its distinctive location, clinical course, insidious onset, and the relative large size of the tumor during presentation. These tumors are slow-growing and clinical symptoms vary according to involvement of different structures including the spinal cord, vertebral artery, lower cranial nerves, and medulla oblongata. Controversies regarding appropriate surgical approach for resection of tumor in this unique location continue. Tumors in the posterior or posterolateral region of the foramen magnum is accessible by midline suboccipital approach. The anterior and anterolateral tumors are encountered by various modifications of the far lateral approach. Drilling of condylar fossa is adequate in most of the cases as tumors often create a surgical corridor. However, an anterior tumor with significant extension on both sides of midline may require variable amounts of condyle resection. Here we review the FMMs with an emphasis on surgical approaches.
Insights
Foramen magnum meningiomas (FMMs) present unique challenges due to their location. This review emphasizes surgical approaches for these complex tumors, highlighting techniques for various tumor locations.
Area of Science:
- Neurosurgery
- Oncology
Background:
- Foramen magnum meningiomas (FMMs) are challenging tumors due to their location and potential for significant neurological compromise.
- Symptoms vary widely based on involvement of critical structures like the spinal cord, lower cranial nerves, and brainstem.
Purpose of the Study:
- To review foramen magnum meningiomas (FMMs).
- To emphasize and compare surgical approaches for FMM resection.
Main Methods:
- Review of literature focusing on surgical techniques for foramen magnum meningiomas.
- Discussion of anatomical considerations and surgical corridor modifications.
Main Results:
- Posterior and posterolateral FMMs are accessible via midline suboccipital approach.
- Anterior and anterolateral FMMs often require modifications of the far lateral approach, potentially involving condylar drilling or resection.
Conclusions:
- Surgical approach selection for FMMs depends on tumor location and extension.
- Careful surgical planning is crucial for successful resection and minimizing neurological deficits.
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