Foramen magnum meningioma approached by the midline subtonsilar approach - Revisiting Cushing's classification of craniospinal meningiomas.

BACKGROUND

The management of foramen magnum meningiomas (FMMs) has been a challenge for skull base neurosurgeons. Since the initial description of a FMM in 1872, various surgical approaches have been described. Posterior and posterolateral FMMs are safely removed through a standard midline suboccipital approach. Nevertheless, we still face controversy regarding the management of anterior or anterolateral lesions.

CASE DESCRIPTION: A 47-year-old patient presented with progressive headaches, unsteadiness, and tremor. Magnetic resonance imaging showed an FMM that caused significant displacement of the brainstem.

CONCLUSION

This operative video highlights a safe and effective surgical technique for the resection of an anterior foramen magnum meningioma.