Foramen magnum and upper cervical cord tumors. Diagnostic problems

Five of six patients with foramen magnum and upper cervical cord tumors were inadequately treated owing to erroneous diagnoses. The time course from the onset of the disease to surgery ranged from six to 96 months (average, 37.3 months). Occipitalgia and neck stiffness are often of diagnostic importance, and foramen magnum and upper cervical cord tumors should be considered when these conditions are accompanied by upper motor neuron disturbance and/or sensory disturbance. Myelography, with careful examination up to the foramen magnum, is essential to establishing a diagnosis. CT scanning and vertebral angiography are also indispensable prior to surgery, as they offer important information as to tumor size and the distribution of nutritive arteries to the tumor.