Endoscopic Endonasal Approach to Foramen Magnum Meningioma: Two-Dimensional Surgical Video

Mansilla, Raíssa; Prevedello, Daniel M.; Lima, Lázaro de; Carrau, Ricardo L.; Landeiro, José Alberto

doi:10.1016/j.wneu.2020.02.026

Cited by 2 publications

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“…Several surgical approaches can be considered when the FMM resection is planned including the midline suboccipital approach, far-lateral approach, extreme-lateral approach, and anterior approach. 6 It is generally accepted that the extreme-lateral approach and far-lateral approach are used for anteriorly located FMMs, whereas posterior FMMs are feasible for the standard midline suboccipital approach. 7 That statement is caused by the fact that resection of anteriorly or anterolaterally localized FMMs via posterior midline approach resulted in a lower extent of resection and high morbidity due to significant brainstem retraction.…”

Section: Discussionmentioning

confidence: 99%

Total resection of foramen magnum meningioma via a far-lateral approach – a case report

Szymoniuk,

Sakwa,

Domagalski

et al. 2024

Eur J Clin Exp Med

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Introduction and aim. The foramen magnum is a rare location of meningioma development, accounting for 1.8 to 3.2% of all reported tumors of this type. Microsurgical resection, representing a gold standard in foramen magnum meningioma treat ment, may result in various neurological deficits or incomplete resection due to challenging anatomical conditions. Currently, even surgical resections of foramen magnum meningioma conducted by experienced neurosurgeons are burdened by a relatively high complication rate of 17.2% Description of the case. We report the case of a 25-year-old male who presented increasing headaches and decreasing activity for 5 months. In his medical history, the patient had been diagnosed with cerebral palsy, autism spectrum disorder, and suffered partial seizures. Magnetic resonance imaging revealed anterolateral foramen magnum meningioma. The tumor was resected via a far-lateral approach. After the surgery, the patient maintained a preoperative neurological state without additional neurological deficits. The post-operative magnetic resonance imaging demonstrated complete tumor removal. Histopatholog ical examination revealed transitional meningioma (WHO grade I). Conclusion. Our case demonstrates that the far-lateral approach can be efficient for the resection of anterolateral foramen magnum meningioma. In such cases, Simpson grade 1 can be achieved without complications, providing immediate relief of symptoms and minimizing the risk of recurrence.

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Section: Discussionmentioning

confidence: 99%

Total resection of foramen magnum meningioma via a far-lateral approach – a case report

Szymoniuk,

Sakwa,

Domagalski

et al. 2024

Eur J Clin Exp Med

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“…Some groups have reported success with the endoscopic endonasal approach to the craniovertebral junction for strictly anterior FMMs. [20][21][22] More traditionally, the extreme lateral or far lateral approach (with or without some degree of condylectomy) 23 has been used for anterior, anterolateral, or lateral tumors within the foramen magnum. 8 Midline suboccipital craniotomies can be employed for posterior or posterolateral tumors of the foramen magnum, which are the least common locations for these tumors.…”

Section: Surgery For Fmmsmentioning

confidence: 99%

Outcomes following stereotactic radiosurgery for foramen magnum meningiomas: a single-center experience and systematic review of the literature

Karras

Texakalidis

Nie

et al. 2022

Neurosurgical Focus

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OBJECTIVE Foramen magnum meningiomas (FMMs) pose a unique challenge given their intimate anatomical relationship with the craniovertebral junction. While resection has been studied extensively, much less has been reported about the use of stereotactic radiosurgery (SRS) for FMMs. This study includes what is to the authors’ knowledge the first systematic review in the literature that summarizes patient and treatment characteristics and synthesizes outcomes following SRS for FMMs. METHODS A retrospective chart review was conducted at a single major academic institution, and a systematic review was performed according to PRISMA guidelines. The initial search on the PubMed and Scopus databases yielded 530 results. Key data extracted from both databases included Karnofsky Performance Status (KPS) score and neurological deficits at presentation, tumor location, treatment indication, target volume, single versus multiple fractions, marginal and maximum doses, isodose line, clinical and radiographic follow-up times, and primary (clinical stability and local control at last follow-up) and secondary (mortality, adverse radiation events, time to regression, progression-free survival) outcomes. RESULTS The study patients included 9 patients from the authors’ institution and 165 patients across 4 studies who received SRS for FMMs. The weighted median age at treatment was 60.2 years, and 73.9% of patients were female. Common presenting symptoms included headache (33.9%), dizziness/ataxia (29.7%), cranial nerve deficit(s) (27.9%), numbness (22.4%), weakness (15.2%), and hydrocephalus (4.2%). Lateral/ventrolateral (64.2%) was the most common tumor location. SRS was utilized as the primary therapy in 63.6% of patients and as salvage (21.8%) or adjuvant (14.5%) therapy for the rest of the patients. Most patients (91.5%) were treated with a single fraction. A tumor with a weighted median target volume of 2.9 cm3 was treated with a weighted median marginal dose, maximum dose, and isodose line of 12.9 Gy, 22.8 Gy, and 58%, respectively. Clinical stability and local control at last follow-up were achieved in 98.8% and 97.0% of patients, respectively. Only one possible adverse radiation event occurred, and no mortality directly related to the tumor or SRS was reported. CONCLUSIONS In this retrospective analysis and systematic review, the authors demonstrate SRS to be an effective and safe treatment option for carefully selected patients with FMMs.

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Endoscopic Endonasal Approach to Foramen Magnum Meningioma: Two-Dimensional Surgical Video

Cited by 2 publications

References 0 publications

Total resection of foramen magnum meningioma via a far-lateral approach – a case report

Total resection of foramen magnum meningioma via a far-lateral approach – a case report

Outcomes following stereotactic radiosurgery for foramen magnum meningiomas: a single-center experience and systematic review of the literature

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