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

Michał Szymoniuk, Leon Sakwa, Ł. Domagalski, J. Gałązka, Zofia Hoffman, Aleksandra Dryla, Wojciech Czyżewski, Dariusz Szczepanek, Kamil Torres, R. Rola
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Abstract

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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通过远外侧入路全切除枕骨大孔脑膜瘤--病例报告
导言和目的。枕骨大孔是脑膜瘤的罕见发病部位,占所有此类肿瘤报告的 1.8%至 3.2%。显微手术切除是治疗脑膜瘤的金标准,但由于解剖条件具有挑战性,可能会导致各种神经功能缺损或切除不彻底。目前,即使是由经验丰富的神经外科医生实施的枕骨大孔脑膜瘤手术切除,其并发症发生率也相对较高,为 17.2%。我们报告了一例 25 岁男性患者的病例,患者头痛加剧且活动减少已有 5 个月之久。根据病史,患者曾被诊断为脑瘫、自闭症谱系障碍和部分性癫痫发作。磁共振成像显示他患有前外侧枕骨大孔脑膜瘤。肿瘤通过远外侧入路切除。术后,患者保持了术前的神经状态,没有出现其他神经功能障碍。术后磁共振成像显示肿瘤完全切除。组织病理学检查显示为过渡性脑膜瘤(WHO I 级)。结论我们的病例表明,远外侧入路可以有效切除前外侧枕骨大孔脑膜瘤。在这种情况下,Simpson 1 级切除术不会出现并发症,可立即缓解症状并将复发风险降至最低。
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