LOWER CLIVUS AND FORAMEN MAGNUM ANTEROLATERAL MENINGIOMAS - SURGICAL STRATEGY

Lower clivus and anterolateral foramen magnum meningiomas are rare but challenging tumors. Indeed, all access routes to their intradural ant erolateral implantation appear unsafe since highly-functional local st ructures may not be sacrified or even retracted. Anterior and posterio r surgical approaches have specific advantages and limitations. Differ ent lateral extensions oi the posterior approach have been described. They include a transposition of the vertebral artery, a partial occipi tal condylectomy and even the exposure and the section oi the sigmoid sinus. Such posterolateral approaches offer the optimal access to ante rolateral foramen magnum meningiomas and allow a total removal with a minimal morbidity. We report the surgical strategy that we applied for the last 6 anterolateral foramen magnum meningiomas in our department .