Meyer F B, Ebersold M J, Reese D F
J Neurosurg. 1984 Jul;61(1):136-42. doi: 10.3171/jns.1984.61.1.0136.
The authors reviewed 102 documented cases of benign extramedullary tumors of the foramen magnum treated at their institution between 1924 and 1982. There was 78 meningiomas, 23 neurofibromas, and one teratoma. Approximately 40% of the patients had a normal neurological examination upon first evaluation. The most frequent presenting complaints were suboccipital neck pain, dysesthesias, gait disturbances, weakness, and hand clumsiness. The average time from initial symptoms to diagnosis was 2 1/4 years. The most common findings included hyperreflexia, arm or hand weakness, Babinski sign, spastic gait, sensory loss, and 11th cranial nerve involvement. Based on these cases, an attempt is made to distinguish foramen magnum tumors from other disease entities by a grouping of signs and symptoms. There is no clinical finding that is pathognomonic. Metrizamide computerized tomography scanning and Pantopaque myelography have been the radiographic tests most commonly used to evaluate the foramen magnum. Recent experience suggests that nuclear magnetic resonance scanning will be a very useful noninvasive means of evaluating the foramen magnum region.
作者回顾了1924年至1982年间在他们机构接受治疗的102例有记录的枕骨大孔良性髓外肿瘤病例。其中有78例脑膜瘤、23例神经纤维瘤和1例畸胎瘤。约40%的患者在首次评估时神经系统检查正常。最常见的主诉是枕下颈部疼痛、感觉异常、步态障碍、虚弱和手部笨拙。从最初症状到诊断的平均时间为2.25年。最常见的体征包括反射亢进、手臂或手部无力、巴宾斯基征、痉挛性步态、感觉丧失和第11对脑神经受累。基于这些病例，试图通过一组体征和症状将枕骨大孔肿瘤与其他疾病实体区分开来。没有具有诊断特异性的临床发现。甲泛葡胺计算机断层扫描和碘苯酯脊髓造影是最常用于评估枕骨大孔的影像学检查。最近的经验表明，核磁共振扫描将是评估枕骨大孔区域的一种非常有用的非侵入性方法。
