ABSTRACT
Lesions situated ventrally and ventrolaterally to the lower brainstem and upper cervical
spinal cord test the skills of neurosurgeons. We present our experience with eight
such patients who underwent the extreme lateral craniocervical approach. The pathologies
encountered include three distal vertebral aneurysms, one prepontine epidermoid, one
anterior foramen magnum meningioma, and three high cervical dumbbell neurofibromas.
All lesions were treated effectively. Postoperatively, the patients improved significantly.
Complications included transient lower cranial nerve paresis in three patients, meningitis
in one patient, and a pseudomeningocele in two patients. All complications improved
with therapy. We conclude that the extreme lateral approach offers excellent visualization
and access with minimal neural retraction for treating these difficult lesions.
KEYWORD
Extreme lateral approach - clivus - cervical spine - dumbbell tumor - vertebral artery
aneurysm - operative technique - skull base
