[Special problems in the diagnosis and therapy of craniospinal tumors]

Tumours in the region of the Foramen magnum are rare (34 cases among more than 1000 infratentorial and 400 spinal tumours). The clinical symptoms can be guiding but they sometimes involve differential-diagnostic difficulties. In dependence upon the starting point and the direction of the development, cerebellar signs or transverse paralysis in the cervical region of the medulla are in the fore. In most cases, supplementary examinations are indispensable (X-ray examinations of the skull and the cervical vertebral column, ventriculography and CT). Angiography is of lesser importance. The anatomical relations of the tumour to its environment not only form the clinical picture, but also bring about therapeutical problems. The use of microsurgical methods has improved the prognosis a little, but nevertheless these disease pictures should be considered to be very serious.