Foramen magnum meningiomas: surgical treatment in a single public institution in a developing country

• Main Authors: Benedicto Oscar Colli, Carlos Gilberto Carlotti Junior, João Alberto Assirati Junior, Luis Alencar Biurrum Borba, Vicente de Paulo Martins Coelho Junior, Luciano Neder
• Format: Article
• Language: English
• Published: Academia Brasileira de Neurologia (ABNEURO) 2014-07-01
• Series: Arquivos de Neuro-Psiquiatria
• Subjects: meningiomas do forame magno; tratamento cirúrgico; extensão da ressecção; sobrevida; complicações pós-operatórias
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2014000700528&lng=en&tlng=en

Objective: To analyze the clinical outcome of patients with foramen magnum (FM) meningiomas. Method: Thirteen patients (11 Feminine / 2 Masculine with FM meningiomas operated on through lateral suboccipital approach were studied. Clinical outcome were analyzed using survival (SC) and recurrence-free survival curves (RFSC). Results: All tumors were World Health Organization grade I. Total, subtotal and partial resections were acchieved in 69.2%, 23.1% and 7.7%, respectively, and SC was better for males and RFSC for females. Tumor location, extent of resection and involvement of vertebral artery/lower cranial nerves did not influence SC and RFSC. Recurrence rate was 7.7%. Operative mortality was 0. Main complications were transient (38.5%) and permanent (7.7%) lower cranial nerve deficits, cerebrospinal fluid fistula (30.8%), and transient and permanent respiratory difficulties in 7.7% each. Conclusions: FM meningiomas can be adequately treated in public hospitals in developing countries if a multidisciplinary team is available for managing postoperative lower cranial nerve deficits.