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Vol. 5. Issue 3.
Pages 230-236 (January 1994)
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Vol. 5. Issue 3.
Pages 230-236 (January 1994)
Meningiomas del agujero magno y primeros segmentos cervicales
G. García-March, J.L. Llacer, J.A. Barcia, V. Bordes, G. Masbout, P. Roldán, J.L. Barcia-Salorio
Departamento de Neurocirugía, Hospital Clínico y Universidad de Valencia, Valencia
Ma.J. Sánchez-Ledesma*, J.M. Gonçalves*, J. Broseta*
* Departamento de Neurocirugía, Universidad de Salamanca, Salamanca
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Resumen

Se presentan 6 pacientes con meningiomas situados en el agujero magno recogidos durante los dos últimos años. La clínica inicial que presentaban fue totalmente inespecífica simulando la mayoríade ellos un cuadro de espondilosis cervical. El diagnóstico morfológico de la lesión se basó en la TC y RM de fosa posterior y primeros segmentos cervicales. Con estas pruebas se confirmó la presencia de una masa tumoral, de carácter intradural y de contornos bien definidos, con presentación lateral en 4 casos y anterior en 2. En todos los casos se procedió de forma precoz a la resección total de la masa tumoral intradural por vía posterior a través de una craniectomía suboccipital y laminectomía cervical superior. Tras un período de seguimiento de 9,5 meses los resultados pueden considerarse como favorables, al aliviarse la sintomatología previa en todos los casos, salvo en uno donde persiste la hemiparesia inicial, y al no haberse detectado recidivas tumorales. La morbilidad de la técnica ha sido mínima y la mortalidad nula. El estudio anatomopatológico confirmó en todos los casos el diagnóstico de meningioma.

Palabras clave:
Agujero magno
Meningioma
Resonancia magnética
Tomografía computada
Abordaje posterior
Summary

Six patients with foramen magnum meningioma treated during the last two years are presented. Initial symptoms were reather ambiguous, mimicking cervical spondylosis in most of the cases. Definitive diagnosis was confirmed by posterior fossa and upper cervical canal CT scanning and MRI. With these imaging procedures a well delimited intradurally and extramedullary tumoral mass was found in all cases which was located laterally in 4 cases and anteriorly in 2 cases. In all cases, the intradural tumor was completely removed through a posterior approach via suboccipital craniectomy and upper cervical laminectomy. The diagnosis of meningioma was demonstrated by pathological study. After a mean follow-up of 9,5 months, the clinical outcome was satisfactory in most of the cases. In 5 patients marked recovery was observed and the other patient developed discrete hemiparesis. Recurrences have not been detected.

Key words:
Foramen magnum
Meningioma
Magnetic resonance
Computerized tomography
Posterior approach

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