CC BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2019; 80(S 04): S355-S357
DOI: 10.1055/s-0039-1698828
Skull Base: Operative Videos
Georg Thieme Verlag KG Stuttgart · New York

Far Lateral Craniotomy for Resection of Foramen Magnum Meningioma

Robert T. Wicks
1  Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States
,
Xiaochun Zhao
1  Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States
,
Celene B. Mulholland
1  Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States
,
Peter Nakaji
1  Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States
› Author Affiliations
Further Information

Publication History

01 April 2019

25 August 2019

Publication Date:
22 October 2019 (online)

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.

Disclosures

None.


Financial Support

None.