Watanabe Kentaro
Department of Neurosurgery, Jikei University School of Medicine.
No Shinkei Geka. 2024 Jul;52(4):772-781. doi: 10.11477/mf.1436204976.
The jugular foramen, also known as the foramen magnum, is a highly intricate region of the skull base through which numerous critical blood vessels and nerves traverse. Meningiomas, the most common tumors in neurosurgical pathology, can arise at any location where the meninges are present, posing significant challenges. Meningiomas involving the jugular foramen and sublingual neural tube are particularly notable for their potential to extend from intracranial to extracranial sites, necessitating familiarity with extracranial anatomy, which is not typically encountered in clinical practice. A comprehensive understanding of anatomical characteristics, along with an ample field of view and working space, is crucial for handling the cerebellum, brainstem, and nerves meticulously. The use of surgical support tools such as neuromonitoring and navigation is essential for enhancing the safety of the procedure. Furthermore, preparedness for treatment options, rehabilitation, and adjunctive therapies is vital in the event of neurological symptoms such as those affecting the glossopharyngeal, vagal, or hypoglossal nerves.
颈静脉孔,也称为枕骨大孔,是颅底一个高度复杂的区域,众多重要血管和神经从中穿过。脑膜瘤是神经外科病理学中最常见的肿瘤,可发生在任何有脑膜的部位,带来重大挑战。累及颈静脉孔和舌下神经管的脑膜瘤尤其值得注意,因为它们有可能从颅内延伸至颅外部位,这就需要熟悉颅外解剖结构,而这在临床实践中并不常见。全面了解解剖特征,以及充足的视野和操作空间,对于精细处理小脑、脑干和神经至关重要。使用神经监测和导航等手术辅助工具对于提高手术安全性至关重要。此外,对于如影响舌咽神经、迷走神经或舌下神经等神经症状的治疗方案、康复和辅助治疗做好准备至关重要。