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Microsurgical Gross Total Resection of Foramen Magnum Meningioma via Far Lateral Approach

Foramen magnum meningiomas are one of the most challenging tumors for skull base neurosurgeons due to their proximity to critical neurovascular structures. The far-lateral approach demonstrated here facilitates access to lesions involving the anterior portion of the foramen magnum. In this video, we...

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Autores principales: Sayyahmelli, Sima, Başkaya, Mustafa K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2019
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6864356/
https://www.ncbi.nlm.nih.gov/pubmed/31750062
http://dx.doi.org/10.1055/s-0039-1695063
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author Sayyahmelli, Sima
Başkaya, Mustafa K.
author_facet Sayyahmelli, Sima
Başkaya, Mustafa K.
author_sort Sayyahmelli, Sima
collection PubMed
description Foramen magnum meningiomas are one of the most challenging tumors for skull base neurosurgeons due to their proximity to critical neurovascular structures. The far-lateral approach demonstrated here facilitates access to lesions involving the anterior portion of the foramen magnum. In this video, we present a 62-year-old woman with hand numbness and weakness. The patient had significant difficulty in fine motor movements of both hands. In the neurological examination, she had a significant right-hand intrinsic muscle weakness and mild quadriparesis. Magnetic resonance imaging (MRI) showed a dural-based homogeneously enhancing extra-axial mass in the anterior foramen magnum with a significant mass effect on the brain stem and the upper cervical cord. The decision was made to proceed with a far lateral transcondylar skull base approach including partial C1 laminectomy. The surgery and postoperative course were uneventful. The postoperative MRI showed gross total resection of the mass. The histopathology indicated a WHO (World health Organization) grade-I meningioma. The patient's postoperative course was uneventful. She improved to normal neurological function within several weeks and continues to do well without recurrence at 20 months' follow-up. In this video, we demonstrated important steps for the microsurgical resection of these challenging lesions. The link to the video can be found at: https://youtu.be/_nuX2Y7YU9w .
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spelling pubmed-68643562020-12-01 Microsurgical Gross Total Resection of Foramen Magnum Meningioma via Far Lateral Approach Sayyahmelli, Sima Başkaya, Mustafa K. J Neurol Surg B Skull Base Foramen magnum meningiomas are one of the most challenging tumors for skull base neurosurgeons due to their proximity to critical neurovascular structures. The far-lateral approach demonstrated here facilitates access to lesions involving the anterior portion of the foramen magnum. In this video, we present a 62-year-old woman with hand numbness and weakness. The patient had significant difficulty in fine motor movements of both hands. In the neurological examination, she had a significant right-hand intrinsic muscle weakness and mild quadriparesis. Magnetic resonance imaging (MRI) showed a dural-based homogeneously enhancing extra-axial mass in the anterior foramen magnum with a significant mass effect on the brain stem and the upper cervical cord. The decision was made to proceed with a far lateral transcondylar skull base approach including partial C1 laminectomy. The surgery and postoperative course were uneventful. The postoperative MRI showed gross total resection of the mass. The histopathology indicated a WHO (World health Organization) grade-I meningioma. The patient's postoperative course was uneventful. She improved to normal neurological function within several weeks and continues to do well without recurrence at 20 months' follow-up. In this video, we demonstrated important steps for the microsurgical resection of these challenging lesions. The link to the video can be found at: https://youtu.be/_nuX2Y7YU9w . Georg Thieme Verlag KG 2019-12 2019-10-15 /pmc/articles/PMC6864356/ /pubmed/31750062 http://dx.doi.org/10.1055/s-0039-1695063 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Sayyahmelli, Sima
Başkaya, Mustafa K.
Microsurgical Gross Total Resection of Foramen Magnum Meningioma via Far Lateral Approach
title Microsurgical Gross Total Resection of Foramen Magnum Meningioma via Far Lateral Approach
title_full Microsurgical Gross Total Resection of Foramen Magnum Meningioma via Far Lateral Approach
title_fullStr Microsurgical Gross Total Resection of Foramen Magnum Meningioma via Far Lateral Approach
title_full_unstemmed Microsurgical Gross Total Resection of Foramen Magnum Meningioma via Far Lateral Approach
title_short Microsurgical Gross Total Resection of Foramen Magnum Meningioma via Far Lateral Approach
title_sort microsurgical gross total resection of foramen magnum meningioma via far lateral approach
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6864356/
https://www.ncbi.nlm.nih.gov/pubmed/31750062
http://dx.doi.org/10.1055/s-0039-1695063
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