Baldoncini Matias, Luzzi Sabino, Almeida Joao P, Contreras-López William Omar, La Corte Emanuele, Ordóñez-Rubiano Edgar G, Campero Alvaro
Laboratory of Microsurgical Neuroanatomy, Second Chair of Gross Anatomy, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.
Department of Neurological Surgery, Hospital San Fernando, Buenos Aires, Argentina.
Front Neurol. 2023 Jul 17;14:1228285. doi: 10.3389/fneur.2023.1228285. eCollection 2023.
Gross-total resection of foramen magnum meningiomas remains the gold standard of treatment and should be performed whenever possible. The transcondylar approach (and its variations) represents the most used approach for meningiomas located in the lateral or anterior borders of the foramen magnum. Endoscopic transclivus approaches represent a useful option in selected cases of anterior midline foramen magnum meningiomas, to be performed in centers with advanced experience in endoscopic skull base surgery, with the caveats of increased risk of postoperative cerebrospinal fluid leak. Alternatively, radiosurgery remains an option for well-selected cases, especially for the management of asymptomatic patients with small enlarging tumors. Advances in molecular profiling, as well as genetic analysis, may guide adjuvant treatment.
枕骨大孔脑膜瘤的全切除仍然是治疗的金标准，应尽可能进行。经髁入路（及其变体）是位于枕骨大孔外侧或前缘的脑膜瘤最常用的入路。内镜经斜坡入路是枕骨大孔前中线脑膜瘤特定病例的一种有用选择，应在有内镜颅底手术丰富经验的中心进行，需注意术后脑脊液漏风险增加。另外，放射外科仍是精心挑选病例的一种选择，特别是对于无症状且肿瘤逐渐增大的患者的治疗。分子谱分析以及基因分析的进展可能会指导辅助治疗。
