CC BY-NC-ND 4.0 · Asian J Neurosurg 2022; 17(04): 656-660
DOI: 10.1055/s-0042-1758841
Case Report

Far-Lateral Approach for Foramen Magnum Meningioma: An Anatomical Study with Special Reference to Bulbopontine Junction

Nathan Beucler
1   Neurosurgery Department, Sainte-Anne Military Teaching Hospital, Toulon Cedex 9, France
2   Ecole du Val-de-Grâce, French Military Health Service Academy, Paris Cedex 5, France
,
Christelle Haikal
3   Department of Radiology, Timone University Hospital, Assistance Publique, Hôpitaux de Marseille (APHM), Marseille, France
,
Aurore Sellier
1   Neurosurgery Department, Sainte-Anne Military Teaching Hospital, Toulon Cedex 9, France
,
Adrien May
4   Neurosurgery Department, Timone University Hospital, APHM, Marseille, France
,
Mikael Meyer
4   Neurosurgery Department, Timone University Hospital, APHM, Marseille, France
,
Stéphane Fuentes
4   Neurosurgery Department, Timone University Hospital, APHM, Marseille, France
5   Chief of Spine Unit, Timone University Hospital, APHM, Marseille, France
› Author Affiliations

Abstract

Intracranial meningiomas are sometimes located anteriorly to the foramen magnum and can cause disabling long tract symptoms. The far-lateral approach has been developed to provide an extensive view over the bulbopontine junction and the surrounding lower cranial nerves and upper spinal nerves with a good control on the vertebral artery, allowing the safe resection of such tumors. It is the report of a case with anatomical study before and after the removal of the meningioma. The use of the far-lateral approach allowed us to (1) control the vertebral artery in its V3 (Atlantic extradural) and V4 (intradural) portion (2) have an optimal visibility on the lower cranial nerves, the upper spinal nerves, and the bulbopontine junction, and (3) perform a Simpson 2 resection of the tumor that was inserted between the lower clivus and the upper odontoid process. Beyond its interest for the safe resection of tumors located anteriorly to the foramen magnum, the far-lateral approach is of particular anatomical interest. It allowed us to review the anatomy of the craniocervical junction.



Publication History

Article published online:
10 December 2022

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