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DOI: 10.1055/s-0029-1246138
© Georg Thieme Verlag KG Stuttgart · New York
Foramen Magnum Meningioma: Successful Surgical Resection in a 76-year-old Nigerian
Publikationsverlauf
Publikationsdatum:
29. März 2010 (online)
Introduction
Foramen magnum meningioma (FMM) is a very rare intracranial lesion[1]. It constitutes such a small percentage (about 2%) of brain tumors[2] that even high volume neurosurgical centers in Western countries report series averaging only one case per year[2] [3]. One explanation for this rarity is the difficulty in making a clinical diagnosis of FMM, especially before the advent of diagnostic magnetic resonance imaging (MRI)[4] [5] [6]. The other, more important, reason, however, is the great technical challenge of tumor-ablative surgery in the foramen magnum, a highly limited bony region crowded over by many critical neural-vascular structures of the cervicomedullary junction[7] [8] [9]. This may actually be the main reason why reports of surgical treatment of FMM are much rarer still from resource-poor settings. We present one case recently managed successfully in such a practice setting in Nigeria. We are not aware of any other similar report in the accessible literature from Africa.
References
- 1 Marin Sanabria EA, Ehara K, Tamaki N. Surgical experience with skull base approaches for foramen magnum meningioma. Neurol Med Chir (Tokyo). 2002; 42 (11) 472-478 discussion 479–880
- 2 Boulton MR, Cusimano MD. Foramen magnum meningiomas: concepts, classifications, and nuances. Neurosurg Focus. 2003; 14 (6) e10
- 3 Bassiouni H, Ntoukas V, Asgari S. et al . Foramen magnum meningiomas: clinical outcome after microsurgical resection via a posterolateral suboccipital retrocondylar approach. Neurosurgery. 2006; 59 (6) 1177-1185 discussion 1185–1187
- 4 Chakravarty K, Scott DG, Dick D. et al . Cervical spondylotic myelopathy with occult foramen magnum meningioma – a case for MRI?. Postgrad Med J. 1993; 69 (815) 720-723
- 5 Kandenwein JA, Richter HP, Antoniadis G. Foramen magnum meningiomas – experience with the posterior suboccipital approach. Br J Neurosurg. 2009; 23 (1) 33-39
- 6 Tsao GJ, Tsang MW, Mobley BC. et al . Foramen magnum meningioma: Dysphagia of atypical etiology. J Gen Intern Med. 2008; 23 (2) 206-209
- 7 Bruneau M, George B. Foramen magnum meningiomas: detailed surgical approaches and technical aspects at Lariboisiere Hospital and review of the literature. Neurosurg Rev. 2008; 31 (1) 19-32 discussion 33
- 8 Pamir MN, Kilic T, Ozduman K. et al . Experience of a single institution treating foramen magnum meningiomas. J Clin Neurosci. 2004; 11 (8) 863-867
- 9 Borba LA, de Oliveira JG, Giudicissi-Filho M. et al . Surgical management of foramen magnum meningiomas. Neurosurg Rev. 2009; 32 (1) 49-58
- 10 Heros RC. Lateral suboccipital approach for vertebral and vertebrobasilar artery lesions. J Neurosurg. 1986; 64 (4) 559-562
- 11 Suhardja A, Agur AM, Cusimano MD. Anatomical basis of approaches to foramen magnum and lower clival meningiomas: comparison of retrosigmoid and transcondylar approaches. Neurosurg Focus. 2003; 14 (6) e9
- 12 George B, Lot G, Boissonnet H. Meningioma of the foramen magnum: a series of 40 cases. Surg Neurol. 1997; 47 (4) 371-379
- 13 Sen CN, Sekhar LN. An extreme lateral approach to intradural lesions of the cervical spine and foramen magnum. Neurosurgery. 1990; 27 (2) 197-204
- 14 Goel A, Desai K, Muzumdar D. Surgery on anterior foramen magnum meningiomas using a conventional posterior suboccipital approach: a report on an experience with 17 cases. Neurosurgery. 2001; 49 (1) 102-106 discussion 106–107
Correspondence
Dr. A. O. Adeleye
Department of Neurological
Surgery
University College
Hospital PMB 5116
Ibadan
Nigeria
Telefon: +234 702 846 2539
Fax: +234 2 241 3545
eMail: femdoy@yahoo.com