Abstract
The foramen magnum is a rare location for meningiomas to occur. If present, they most often develop anterior to the neuraxis and below the vertebral artery. The location and relationship with the neuraxis and the vertebral artery is nowadays easily defined with magnetic resonance imaging (MRI) studies. Their removal is necessary except in patients in bad condition or in those with a limited life expectancy. It is unanimously accepted that the posterolateral approach, also named far lateral, is the only good option, when one considers a surgical treatment. It necessitates the control of the vertebral artery in the groove of the posterior arch of the atlas. Subperiosteal dissection with preservation of the periosteal sheath surrounding the vertebral artery and its venous plexus is the key point of the exposure. It is never useful to drill any part of the occipital condyle or lateral mass of the atlas. As such, craniocervical fixation after removal of the meningioma is not necessary.
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Video 43.1
Resection of an anterior foramen magnum meningioma through a far lateral approach. (MP4 274899 kb)
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Bruneau, M., George, B. (2016). Meningiomas of the Craniocervical Junction. In: van de Kelft, E. (eds) Surgery of the Spine and Spinal Cord. Springer, Cham. https://doi.org/10.1007/978-3-319-27613-7_43
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DOI: https://doi.org/10.1007/978-3-319-27613-7_43
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