gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Foramen magnum meningiomas: clinical results in a consecutive series treated microsurgically via a conventional suboccipital approach

Foramen magnum Meningeome: klinische Ergebnisse nach mikrochirurgischer Resektion über einen konventionellen suboccipitalen Zugang

Meeting Abstract

Suche in Medline nach

  • corresponding author H. Bassiouni - Neurochirurgische Klinik, Universitätsklinikum Essen
  • S. Asgari - Neurochirurgische Klinik, Universitätsklinikum Essen
  • D. Stolke - Neurochirurgische Klinik, Universitätsklinikum Essen

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc10.05.-07.05

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0118.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Bassiouni et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

In recent years several reports have been published propagating resection of the occipital condyle for adequate exposure and removal of foramen magnum meningiomas. We report our surgical experience in a consecutive series of patients who underwent resection of these tumors via a conventional midline suboccipital craniotomy.

Methods

The clinical, radiological and intraoperative data in a consecutive series of 12 patients treated microsurgically between January 1989 and January 2004 in our institution were retrospectively reviewed.

Results

The nine women and three men had a mean age of 53.7 years (range 33 yrs to 70 yrs). Main presenting symptoms were a paraparesis in five and gait ataxia in four patients. Mean duration of these symptoms prior to hospital admission was 13 months and 6 months, respectively. Preoperative magnetic resonance imaging (MRI) revealed a ventro-lateral location of the tumor in eight patients and a ventral dural attachment in three cases. The tumor was situated on the posterior rim of the foramen magnum in one case. All patients were operated on in the semi-sitting position via a conventional midline suboccipital craniotomy. Resection of the occipital condyle was not performed in any case. To enhance exposure according to tumor extension, a laminectomy of C1 was added in five patients, a laminectomy of C1 and C2 in two cases, a hemilaminectomy of C1 in three cases and a hemilaminectomy of C1 and C2 in two patients. Extent of surgical resection according to Simpson’s classification system was grade I in the dorsally located tumor, grade II in nine tumors and grade III in two meningiomas with tumor remnants left on the medulla oblongata. After surgery, regression or amelioration of preoperative symptoms was recorded in ten patients. One patient treated for recurrent tumor deteriorated and required permanent assistance. One patient had died due to mediastinitis following complicated tracheostomy. After a mean follow-up of 7.5 years (range 2 yrs to 16 yrs) with clinical and MRI examination none of the patients had experienced a de novo tumor recurrence.

Conclusions

The conventional midline suboccipital approach offers adequate exposure for microsurgical resection of foramen magnum meningiomas. Resection of the occipital condyle is not required even in tumors with a ventral dural attachment.