Foramen magnum meningioma approached by the midline subtonsilar approach - Revisiting Cushing's classification of craniospinal meningiomas

Roberto Leal da Silveira; Daniela de Oliveira Von Zuben; Raphael Bertani; Jose Alberto Landeiro

doi:10.25259/SNI_939_2022

Foramen magnum meningioma approached by the midline subtonsilar approach - Revisiting Cushing's classification of craniospinal meningiomas

Surg Neurol Int. 2023 Feb 17:14:56. doi: 10.25259/SNI_939_2022. eCollection 2023.

Authors

Roberto Leal da Silveira¹, Daniela de Oliveira Von Zuben², Raphael Bertani², Jose Alberto Landeiro³

Affiliations

¹ Department of Neurosurgery, Madre Teresa Hospital, Belo Horizonte, São Paulo, Brazil.
² Department of Vascular and Skull Base, University of Sao Paulo, São Paulo, Brazil.
³ Department of Neurosurgery, Federal Fluminense University, Niteroi, Brazil.

Abstract

Background: The management of foramen magnum meningiomas (FMMs) has been a challenge for skull base neurosurgeons. Since the initial description of a FMM in 1872, various surgical approaches have been described. Posterior and posterolateral FMMs are safely removed through a standard midline suboccipital approach. Nevertheless, we still face controversy regarding the management of anterior or anterolateral lesions.

Case description: A 47-year-old patient presented with progressive headaches, unsteadiness, and tremor. Magnetic resonance imaging showed an FMM that caused significant displacement of the brainstem.

Conclusion: This operative video highlights a safe and effective surgical technique for the resection of an anterior foramen magnum meningioma.

Keywords: Cushing; Foramen magnum; Meningioma; Subtonsilar approach.

Publication types

Case Reports