Sugiyama S, Kodama N, Yoshimoto T, Suzuki J
No Shinkei Geka. 1980 Nov;8(11):1101-5.
A 36-year-old male with craniospinal type of foramen magnum neurinoma removed totally was reported. Foramen magnum neurinoma shows various clinical symptoms called foramen magnum syndrome but none of them is specific. Therefore almost all the cases in the literature have been misdiagnosed as degenerative or demyelinating diseases. The best way for correct diagnosis is to suspect the existence of the tumor. Conventional suboccipital craniectomy has been adopted to remove the tumors. But craniospinal type of this tumor usually develops in the anterior part of the foramen magnum. Therefore we approached to the tumor from aside in the lateral position. In this approach, we can avoid tissue damage of cerebellum and medulla due to retraction and can reach near the midportion of the posterior fossa. The importance of checking respiration during surgery is also emphasized, because surgical intervention is carried out around the medulla oblongata.
报告了1例36岁男性颅颈型枕骨大孔神经鞘瘤被完全切除的病例。枕骨大孔神经鞘瘤表现出各种被称为枕骨大孔综合征的临床症状，但均无特异性。因此，文献中几乎所有病例都被误诊为退行性或脱髓鞘疾病。正确诊断的最佳方法是怀疑肿瘤的存在。传统的枕下颅骨切除术已被用于切除肿瘤。但这种肿瘤的颅颈型通常发生在枕骨大孔的前部。因此，我们采用侧卧位从一侧接近肿瘤。通过这种方法，我们可以避免因牵拉导致的小脑和延髓组织损伤，并可到达后颅窝中部附近。由于手术操作是在延髓周围进行的，因此术中检查呼吸的重要性也得到了强调。
