Left far-lateral approach for resection of a large foramen magnum meningioma encasing the dominant vertebral artery: 2-Dimensional operative video

Abstract

Tumors at the craniocervical junction represent a formidable challenge due to its intimate association with the medulla and cervical spinal cord, lower cranial nerves, and vertebral artery (VA). Foramen magnum meningioma (FMM) reparents 2% of all intracranial meningiomas and 4% of posterior fossa meningiomas. The far lateral approach is preferred for FMM with VA involvement. Here, we describe a case of a 58-year-old woman who presented with headache, nausea and vomiting and gait disturbance and was found to have large FMM encasing the dominant VA. The patient was treated with a left far lateral approach with limited condylectomy resulting in gross total resection and preservation of lower cranial nerves function.