Abstract
Objective Foramen magnum meningiomas present a formidable challenge to resection due to frequent
involvement of the lower cranial nerves and vertebrobasilar circulation. The video
shows the use of a far lateral craniotomy to resect a foramen magnum meningioma.
Design, Setting, and Participant A 49-year-old woman presented with neck pain and was found to have a large foramen
magnum meningioma ([Fig. 1A, B]). Drilling of the posterior occipital condyle was required to gain access to the
lateral aspect of the brain stem. The amount of occipital condyle resection varies
by patient and pathology.
Outcome/Result Maximal total resection of the tumor was achieved ([Fig. 1B, C]), and the patient was discharged on postoperative day 4 with no neurologic deficits.
The technique for tumor microdissection ([Fig. 2]) is shown in the video.
Conclusion Given the close proximity of foramen magnum meningiomas to vital structures at the
craniocervical junction, surgical resection with careful microdissection and preservation
of the overlying dura to prevent postoperative pseudomeningocele is necessary to successfully
manage this pathology in those patients who are surgical candidates.
The link to the video can be found at: https://youtu.be/Mds9N1x2zE0.
Keywords
far lateral - foramen magnum - occipital condyle
