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Journal of Craniovertebral Junction and Spine
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ORIGINAL ARTICLE
Year : 2010  |  Volume : 1  |  Issue : 1  |  Page : 10-17

Classification system of foramen magnum meningiomas


1 Department of Neurosurgery, Erasme Hospital, Brussels, Belgium
2 Lariboisière Hospital, Paris, France

Correspondence Address:
M Bruneau
Hopital Erasme, Service de Neurochirurgie, Route de Lennik, 808, 1070 Brussels
Belgium
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-8237.65476

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Background: Foramen magnum meningiomas (FMMs) are challenging tumors. We report a classification system based on our experience of 107 tumors. Materials and Methods: The three main algorithm criteria included the compartment of development of the tumor, its dural insertion, and its relation to the vertebral artery. Results: The compartment of development was most of the time intradural (101/107, 94.4%) and less frequently extradural (3/107, 2.8%) or both intra-extradural. (3/107, 2.8%). When developed inside the intradural compartment, FMMs were subdivided into posterior (6/104, 5.8%), lateral (57/104, 54.8%), and anterior (41/104, 39.4%), if their insertion was respectively posterior to the dentate ligament, anterior to the dentate ligament without or with extension over the midline. Anterior and lateral intradural lesions grew below (77/98, 78.6%), above (16/98, 16.3%), or on both sides (5/98, 5.1%) of the VA. Only three cases of extraduralFMMs (3/107, 2.8%) were resected by an antero-lateral approach while all the other ones (104/107, 97.2%) were removed successfully by a postero-lateral approach. Lower cranial nerves were displaced superiorly in FMM growing below the VA but their position cannot be anticipated in other situations. Conclusions: This classification system helps for defining the best surgical approach but also for anticipating the position of the lower cranial nerves and therefore for reducing the surgical morbidity.


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