Title: Foramen Magnum Meningioma: A case report and review of literature

Biography:

Prarthana Subedi is a 4th year medical student at the Nepalese army institute of health sciences college of medicine, Nepal and she is also a member of President : Walter E. Dandy Neurosurgical student club of Nepal.

Abstract

Introduction:
Foramen magnum meningioma’s are rare forms of meningioma’s. Among all the meningioma’s, only about 1 to 3% arises at foramen magnum level. ¹The neurological signs and symptoms are very bizarre for these meningioma’s.  There are very few case reports on Foramen Magnum Meningioma’s in Nepal

Case presentation:
A 62 year old male with co-morbidities like, Right sided hemiparesis, Hypertension and Diabetes Mellitus II presented to the Emergency department or an increase in weakness of the right arm and leg for 2 days and Fever for 1 day. He suffered a stroke 2 years ago with right sided hemiparesis. CT images revealed a mass in the poster lateral foramen magnum area. Meningioma of Foramen magnum was suspected, which was confirmed by MRI.  The tumor was excised by far lateral approach with laminectomy at the level of C1 and C2 vertebrae, the operation lasting for 8 hours² anticipated complications were blood loss, infections and CSF leak post-surgery.
Follow up outcomes could not be ascertained because of the COVID lockdown.

Conclusion:
Foramen magnum meningioma’s are rare tumors arising from the Craniocervical junction with indolent presentation and a late diagnosis. If left untreated, the outcomes can be debilitating, with respiratory arrest. We present a case of a 65 year old male presented to our department treated with the resection of the tumor with a far-lateral approach. The follow-up outcomes of the patient however cannot be ascertained. This is one of the few case reports on Foramen Magnum Meningioma coming out of Nepal.

References

1. Bureau M, George B. Classification system of foramen magnum meningiomas.J Craniovertebr Junction Spine. 2010 Jan; 1(1):10. [ DOI | PubMed | Full Text ] 
2. Borba LA, de Oliveira JG, Giudicissi-Filho M, Colli BO. Surgical management of foramen magnum meningioma’s. Neurosurgical review. 2009 Jan; 32(1):49-60. [DOI | PubMed ]