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At least 865 records · Page 48Linked to original sources
PubMed2006

[Anterior and lateral foramen magnum meningiomas].

We report our experience with 11 cases of foramen magnum meningiomas, eight originating inside the posterior fossa and three in the caudal region. The mean age of the patients was 50.8 years and the main complaint was cervical headache for at least 18.6 months and at the neurological examination, tetraparesis and deficit of the lower cranial nerves were very often observed. All patients were submitted to surgical treatment, always with exposition of the vertebral artery at the entry zone in the dura mater of the posterior fossa, with partial removal of the occipital condyle in only three cases. Total resection was obtained in seven patients and partial removal in the other four due to adherences to vessels and nerves. The prognostic was related to the neurological condition before surgery.

Adult↗
PubMed1999

Avulsion fracture of the anterior half of the foramen magnum involving the bilateral occipital condyles and the inferior clivus--case report.

A 38-year-old male presented with an avulsion fracture of the anterior half of the foramen magnum due to a traffic accident. He had palsy of the bilateral VI, left IX, and left X cranial nerves, weakness of his left upper extremity, and crossed sensory loss. He was treated conservatively and placed in a halo brace for 16 weeks. After immobilization, swallowing, hoarseness, and left upper extremity weakness improved. Hyperextension with a rotatory component probably resulted in strain in the tectorial membrane and alar ligaments, resulting in avulsion fracture at the sites of attachment, the bilateral occipital condyles and the inferior portion of the clivus. Conservative treatment is probably optimum even for this unusual and severe type of occipital condyle fracture.

Accidents, Traffic↗
PubMed2000

Far lateral approach for foramen magnum lesions.

Twelve patients with lesions in the anterior or anterolateral regions of foramen magnum were treated through the far lateral approach. The patients presented with neck pain, dysesthesia, quadriparesis, numbness, respiratory distress, and spastic contractures. Most lesions were meningiomas and neurofibromas, with one patient each with a posterior inferior cerebellar artery aneurysm, neurenteric cyst, and chordoma. All mass lesions were excised totally and the aneurysm was clipped. Three patients had severe respiratory problems preoperatively and two of them died. The other patients made a satisfactory neurological recovery. It was not found necessary to resect the condyle or mobilize the vertebral artery in any of the patients.

Adolescent↗
PubMed1999

Surgical anatomy and morphometric analysis of the occipital condyles and foramen magnum.

Surgical anatomy that provides the basis for dealing with lesions arising in the lower clivus and ventral foramen magnum was reviewed in 8 adult cadaver heads and 76 dry skulls. The extreme lateral transcondylar approach was performed in cadavers; the morphometric analysis was studied in both the cadavers and the skulls. The landmarks, distances and structures were selected in order to guide the surgical operations in this area. In the paper, surgical approaches to this region are reviewed, and the results are discussed from the standpoint of surgical importance.

Adult↗
PubMed1993

The far lateral approach for ventrally placed foramen magnum and upper cervical spine tumours.

Tumours of the foramen magnum region present a considerable surgical challenge. Their location combined with the close anatomical relation to sensitive and important vascular and nervous structures can make total removal difficult and sometimes impossible. Posterior and posteriolateral approaches, despite their simplicity, offer poor exposure and require retraction or rotation of the spinomedullary junction. Anteriolateral extrapharyngeal approaches are restrictive when a spacious superior exposure is necessary, while the vascular structures hidden by the tumours themselves appear only at the end of a rather tedious resection. The direct anterior transoral route, although effective for midline lesions, can be restrictive for laterally placed or broad-based tumours. A true lateral exposure provides an attractive alternative, the only anatomical obstacles being the horizontal part of the vertebral artery and the occipital condyle with its articulation with the lateral atlantal mass. A lateral approach was used in 15 patients with ventrally located tumours of the craniocervical junction, resulting in 12 total and three subtotal removals. In no case has there been inadequate tumour exposure and there were no complications of instability, CSF leak or infection directly related to the operation. Important advantages of the approach include: excellent exposure of the ventral spinomedullary junction, early and safe exposure of vascular structures, preservation of stability, minimal risk of infection, elimination of the need for neuraxis retraction and simplicity of instruments and technique.

Adolescent↗
PubMed1994

Silastic dural substitute: experience of its use in spinal and foramen magnum surgery.

In an attempt to prevent tethering following intradural procedures in the spine or at the foramen magnum silastic film has been inserted as a dural substitute. Magnetic resonance imaging has enabled us to judge the effectiveness of this material in preventing tethering at the operative site. Our experience of Silastic dura substitute in 43 paediatric and adult cases is discussed, and illustrated together with a description of the technique of insertion and an analysis of the complications associated with its use.

Adolescent↗
PubMed1989

Foramen magnum syndrome from pseudogout of the atlanto-occipital ligament. Case report.

The authors report a case of progressive foramen magnum syndrome due to deposits of calcium pyrophosphate dihydrate crystals, which caused reactive hypertrophy in the posterior longitudinal ligament at C-1 and in the transverse ligament of the atlas in an 84-year-old woman. This is the first reported case of symptomatic pseudogout in this anatomic location. Rapid neurological recovery followed transoral decompression of the cervicomedullary junction.

Aged↗
PubMed1991

Intradural extraosseous chordoma in the foramen magnum region. Case report.

Chordomas that are entirely extraosseous and intradural are extremely rare. The tumors described in the literature were observed mostly in the prepontine region. This is the first case reported of an intradural extraosseous chordoma occurring in the foramen magnum region. The tumor was totally excised. The distinction between an intradural extraosseous chordoma and a classic chordoma is important from a clinical viewpoint because of the potential for complete surgical excision and a more benign growth pattern.

Adult↗
PubMed2006

Cervicomedullary decompression for foramen magnum stenosis in achondroplasia.

OBJECT: Achondroplasia is the most common hereditary form of dwarfism, and is characterized by short stature, macrocephaly, and a myriad of skeletal abnormalities. In the pediatric population, stenosis and compression at the level of the cervicomedullary junction commonly occurs. The goal in this study was to assess the outcomes in children with achondroplasia who underwent cervicomedullary decompression. METHODS: Forty-three pediatric patients with heterozygous achondroplasia and foramen magnum stenosis underwent 45 cervicomedullary decompressions at the authors' institution over an 11-year period. After surgical decompression, complete resolution or partial improvement in the preoperative symptoms was observed in all patients. There were no deaths in the treated patients. The surgical morbidity rate was low and usually consisted of a cerebrospinal fluid (CSF) leak in patients in whom the dura mater had been opened (either intentionally or accidentally). This problem was successfully managed in all cases with local measures (wound oversewing) or CSF diversion. CONCLUSIONS: In this review the authors demonstrate that decompression of the cervicomedullary junction in the setting of achondroplasia may be accomplished safely with significant clinical benefit and minimal morbidity.

Achondroplasia↗
PubMed2002

Acute foramen magnum syndrome caused by an acquired Chiari malformation after lumbar drainage of cerebrospinal fluid: report of three cases.

OBJECTIVE AND IMPORTANCE: The perioperative use of lumbar drainage of cerebrospinal fluid (CSF) is relatively common in neurosurgery, and the development of "acquired" Chiari malformations (tonsillar herniation) with lumbar CSF diversion procedures has been reported. CLINICAL PRESENTATION: We describe the history of three patients who developed a foramen magnum syndrome, attributable to acquired Chiari I malformations, after perioperative lumbar drainage of CSF. CONCLUSION: We propose that the mechanism responsible for Chiari I malformations involves a negative pressure gradient between the cranial and spinal regions, created by CSF drainage. Theories regarding the formation of acquired Chiari I malformations, the possible synergistic roles of intracranial pathological conditions and CSF drainage in the development of this entity, and the implications for the use of perioperative lumbar drainage are discussed.

Acute Disease↗
PubMedDate not supplied

[Diagnostic difficulties in tumours of foramen occipitale magnum].

The reported case was diagnosed formerly as multiple sclerosis. On autopsy it was found that disseminated neurological symptoms were caused by a neurofibroma of the foramen magnum. The diagnostic difficulties in cases of tumours in this location are discussed.

Adult↗
PubMed2004

Long latency response in soleus muscle evoked by magnetic stimulation at the foramen magnum.

We performed magnetic stimulation at the level of foramen magnum in healthy subjects to evaluate the long latency response in lower limb muscle. Subjects assumed an upright stance and we recorded electromyographic activities in soleus muscle. A late response at the onset latency of approximately 40 ms was elicited. The late response wasn't induced in other lower limb muscles; anterior tibial muscle, quadriceps femoris muscle, and biceps femoris muscle. Additionally, magnetic stimulation to foot motor cortex, basal occiput and cervical nerve roots did not evoke the response with latency of 40 ms. These results reveal the late response in soleus muscle that has not been previously reported. We speculate that it is involved with the long-loop reflex.

Adult↗
PubMed2005

[Chiari malformation (type 1) with regeneration of removed C1 lamina after foramen magnum decompression: a case report].

We present the case of a 20-year-old female who underwent foramen magnum decompression and laminectomy of C1-C3 as well as incision of only the outer layer of the dura, for her symptomatic Chiari malformation (type 1) with syringomyelia, at the age of 9 years. She required additional surgery with removal of regenerated bone and dural plasty for the remaining and recurrent stenosis. The remaining stenosis may have been caused by the use of a technique without dural plasty and insufficient decompression of the bony structure. Further, the regeneration of C1 lamina could have been responsible for the recurrent stenosis. Her symptoms, which included gait disturbance, hypesthesia, excessive sweating, and nocturnal enuresis, manifested themselves when she was at the age of 2 years and progressed since that time. These symptoms didn't improve after the first surgery. However, after the second surgery, the gait disturbance and nocturnal enuresis were partially resolved. It is rare for new bone generation to necessitate reoperation. However, it should be noticed that careful follow-up is important after decompressive surgery for Chiari malformation in young patients.

Adult↗
PubMedDate not supplied

[Pontine stroke secondary to a foramen magnum meningioma].

INTRODUCTION: Meningioma is one of the most frequent tumours affecting the central nervous system, with an estimated incidence of between 15 and 20% of all brain tumours. They are generally benign and slow growing. Their appearing as a cerebral infarction is very rare. CASE REPORT: A right-handed 75-year-old female patient with a personal history of arterial hypertension, who visited the Emergency Department because of the sudden onset of severe dysarthria, accompanied by loss of strength in the left limbs, supranuclear facial palsy on the left side and Horner syndrome on the right. A computerised tomography scan of the brain revealed a lacunar infarct in said location, with no other appreciable damage. The neurovascular study included a transcranial Doppler, which was unable to insonate the left vertebral artery or the basilar artery. Magnetic resonance imaging of the head revealed a foramen magnum meningioma, with vertebrobasilar vascular distortion. The patient progressed favourably and was submitted to radiosurgery. CONCLUSIONS: The case reported here is unique, since it describes a meningioma of the posterior fossa that appears in the form of the initial symptoms of a pontine stroke due to a vascular disorder.

Aged↗
PubMed1991

[Vertebro-dural arteriovenous fistulae of the foramen magnum with perimedullary venous drainage].

Two cases of dural arteriovenous fistulae of the foramen magnum with perimedullary venous drainage are reported. Their arterial component was a dural branch of a vertebral artery. The localization and the origin of these fistulae appeared very uncommon but could be explained by the embryogenesis of the vertebral arteries, of which the third portion corresponds to the first cervical radicular artery. The first patient had signs and symptoms usually described in this disease, but the second presented a subarachnoid haemorrhage with neither motor and sensory deficit not sphincter disturbance. Myelographic findings, M.R.I. abnormalities and treatment of these rare dural arteriovenous malformations are discussed.

Arteriovenous Fistula↗
PubMed1986

[Pathologic spontaneous activity in a foramen magnum meningioma].

The case history over five years of a finally completely tetraplegic patient is described, in whose plegic muscles massive occurrence of positive sharp waves and fibrillation potentials could be found together with normal neurographic parameters. The mediosagittal MRT of the brainstem gave evidence of a tumor in the craniocervical region. The patient could be discharged in healthy condition ten weeks after removal of a foramen magnum meningioma. Evidence of so-called denervation activity was no longer present. For the clinical neurologist as well as for the electromyographer it is equally important to know that positive sharp waves and fibrillation potentials can also occur in central lesions.

Electromyography↗
PubMed1983

Meningioma of the foramen magnum. Report of a case.

The authors present a typical case of a meningioma of the foramen magnum. Because of the unspecific nature of the patient's symptoms, the present illness had a course of more than seven years. During the last two years of the illness, the diagnosis of multiple sclerosis was assumed. The final diagnosis was established by computed tomography followed by vertebral angiography. The tumor removal was followed by dramatic recovery of the patient. The value of axial and direct coronal computed tomography is emphasized.

Adult↗