Pirotte B, David P, Noterman J, Brotchi J
Department of Neurosurgery, Erasme Hospital, Free University of Brussels, Belgium.
Neurol Res. 1998 Oct;20(7):577-84. doi: 10.1080/01616412.1998.11740567.
Lower clivus and anterolateral foramen magnum meningiomas are rare but challenging tumors. Indeed, all access routes to their intradural anterolateral implantation appear unsafe since highly-functional local structures may not be sacrified or even retracted. Anterior and posterior surgical approaches have specific advantages and limitations. Different lateral extensions of the posterior approach have been described. They include a transposition of the vertebral artery, a partial occipital condylectomy and even the exposure and the section of the sigmoid sinus. Such posterolateral approaches offer the optimal access to anterolateral foramen magnum meningiomas and allow a total removal with a minimal morbidity. We report the surgical strategy that we applied for the last 6 anterolateral foramen magnum meningiomas in our department.
斜坡下部和枕骨大孔前外侧脑膜瘤罕见但具有挑战性。实际上，由于可能无法牺牲甚至牵拉高度功能化的局部结构，通向其硬膜内前外侧植入部位的所有入路似乎都不安全。前后手术入路各有其特定的优势和局限性。已经描述了后入路的不同外侧延伸方式。它们包括椎动脉移位、部分枕髁切除术，甚至乙状窦的显露和切断。这种后外侧入路为枕骨大孔前外侧脑膜瘤提供了最佳的显露途径，并能在最低限度的并发症情况下实现全切。我们报告了我们科室在过去6例枕骨大孔前外侧脑膜瘤手术中应用的手术策略。
