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

Sima Sayyahmelli; Mustafa K. Başkaya

doi:10.1055/s-0039-1695063

Journal of Neurological Surgery Part B: Skull Base, Table of Contents

CC BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2019; 80(S 04): S360-S362
DOI: 10.1055/s-0039-1695063

Skull Base: Operative Videos

Georg Thieme Verlag KG Stuttgart · New York

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

Sima Sayyahmelli

¹Department of Neurological Surgery, University of Wisconsin Medical School, Madison, Wisconsin, United States

,

Mustafa K. Başkaya

¹Department of Neurological Surgery, University of Wisconsin Medical School, Madison, Wisconsin, United States

› Author Affiliations

Abstract

Full Text

PDF Download

Keywords

far lateral transcondylar - foramen magnum meningioma - gross total resection - skull base

Fig. 1 Preoperative MRI in (A) axial, (B) sagittal, and (C) coronal planes shows a dural-based heterogeneous enhancing extra-axial mass in the anterior foramen magnum with a significant mass effect upon the upper cervical cord and postoperative MRI in (A) axial, (B) sagittal, and (C) coronal planes shows a gross total resection of the tumor without recurrence. MRI, magnetic resonance iaging.

Fig. 2 (A) The cadaveric dissections of far lateral approach from our laboratory have demonstrated the extent of access and related anatomic and neurovascular structures via this approach. (B) The cadaveric dissections from our laboratory shows the vertebral artery and the posterior inferior cerebellar artery were exposed. In this approach for the foramen magnum meningioma, only minimal drilling of the occipital condyle is necessary. (C) The intraoperative picture shows the dentate ligament, C1 and C2 nerve roots, and the accessory nerve after dural opening. (D) The intraoperative picture shows the ipsilateral vertebral artery and the rootlets of the hypoglossal nerve. (E) The intraoperative picture shows the contralateral vertebral artery. (F) The intraoperative picture shows the rootlets of the contralateral hypoglossal nerve. DM, dura mater; PICA, posterior inferior cerebellar artery; VA, vertebral artery; PSA, posterior spinal artery.

www.thieme.com/skullbasevideos

www.thieme.com/jnlsbvideos

Quality:

Download

Figures

Fig. 1 Preoperative MRI in (A) axial, (B) sagittal, and (C) coronal planes shows a dural-based heterogeneous enhancing extra-axial mass in the anterior foramen magnum with a significant mass effect upon the upper cervical cord and postoperative MRI in (A) axial, (B) sagittal, and (C) coronal planes shows a gross total resection of the tumor without recurrence. MRI, magnetic resonance iaging.

Fig. 2 (A) The cadaveric dissections of far lateral approach from our laboratory have demonstrated the extent of access and related anatomic and neurovascular structures via this approach. (B) The cadaveric dissections from our laboratory shows the vertebral artery and the posterior inferior cerebellar artery were exposed. In this approach for the foramen magnum meningioma, only minimal drilling of the occipital condyle is necessary. (C) The intraoperative picture shows the dentate ligament, C1 and C2 nerve roots, and the accessory nerve after dural opening. (D) The intraoperative picture shows the ipsilateral vertebral artery and the rootlets of the hypoglossal nerve. (E) The intraoperative picture shows the contralateral vertebral artery. (F) The intraoperative picture shows the rootlets of the contralateral hypoglossal nerve. DM, dura mater; PICA, posterior inferior cerebellar artery; VA, vertebral artery; PSA, posterior spinal artery.