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完整切除无神经血管损伤的单纯枕骨大孔前方脑膜瘤面临巨大挑战:病例报告

Complete resection of pure anterior foramen magnum meningioma without neurovascular injuries poses a big challenge: Case report.

作者信息

Hammed Ali, Mahfoud Moufid, Sulaiman Alaa, Najm Adnan, Hammed Salah

机构信息

Tishreen University Hospital, Department of Neurosurgery. Lattakia, Syria.

Faculty of Medicine. Aleppo, Syria.

出版信息

Ann Med Surg (Lond). 2021 Mar 27;64:102265. doi: 10.1016/j.amsu.2021.102265. eCollection 2021 Apr.

Abstract

INTRODUCTION AND IMPORTANCE

Meningiomas are common neoplasms representing 14.3-19% of all intracranial tumors. Among all the meningiomas, only 1.8-3.2% arises at the foramen magnum (FM) level.Most of the lesions (68%-98%) arising anterolaterally, followed by postolateral, purely posterior and, more rarely, purely anterior.

CASE PRESENTATION

We report a case of A 42-year-old female presented with a history of neck pain with progressive spastic hemiparesis.

CLINICAL DISCUSSION

MRI revealed well-defied pure anterior and on both sides of vertebral artery, foramen magnum lesion. Through conservative transcondylar approach, Lesion was removed totally in a piecemeal fashion. Histopathology revealed meningothelial meningioma. The patient had a dramatic recovery.

CONCLUSION

The exposure allowed by the far-lateral retrocondylar or partial transcondylar approach is adequate for resecting even anterior intradural FMMs.Reports about Foramen magnum meningioma aren't common, but reports on pure anterior foramen magnum meningioma are very rare. The prerequisite for treating FM meningiomas (FMMs) is the perfect knowledge of the surgical anatomy. The opportunity to give the patient a symptom-free and normal life should not be missed in such cases.

摘要

引言与重要性

脑膜瘤是常见肿瘤,占所有颅内肿瘤的14.3%-19%。在所有脑膜瘤中,仅1.8%-3.2%发生于枕骨大孔(FM)水平。大多数病变(68%-98%)起源于前外侧,其次是后外侧、单纯后方,更罕见的是单纯前方。

病例介绍

我们报告一例42岁女性,有颈部疼痛伴进行性痉挛性偏瘫病史。

临床讨论

MRI显示界限清晰的单纯位于前方且在椎动脉两侧的枕骨大孔病变。通过保守的经髁入路,病变被分块完全切除。组织病理学显示为脑膜皮型脑膜瘤。患者恢复良好。

结论

远外侧髁后或部分经髁入路所提供的暴露足以切除甚至是硬膜内前方的枕骨大孔脑膜瘤。关于枕骨大孔脑膜瘤的报道并不常见,但关于单纯前方枕骨大孔脑膜瘤的报道非常罕见。治疗枕骨大孔脑膜瘤(FMMs)的前提是对手术解剖有完善的了解。在这种情况下,不应错过让患者过上无症状正常生活的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0d4/8040125/3bbd607fa381/gr1.jpg

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