Case 2 9 : CraniospinaL meningioma

 

　　颅颈交界部脑膜瘤

 

　　A 36-year-old man came to our attention because of a 2-year history of unsteady gait.  Neurological examination disclosed decreased sensation on the right side and ataxic gait. CT scans showed a craniospinal meningioma. Through a midline suboccipi-tal craniectomy and after removal of the laminae of Cl and C2,the dura is opened in an Y-shaped fashion with the vertical limb of the Y caudal in the midline.  The cranial border of the vertical limb of the dural incision lies at the foramen magnum, and it may encounter the occipital sinus; if this is the case, the sinus is coagulated or clipped.  The dural flap is then tacked up using 4-0sutures placed under tension using hemostats.The tumor located in correspondence of the anterior margin of the foramen magnum and pushing the craniocervical junction posterolaterally was completely removed. The postoperative course was uncomplicated, and the patient was discharged, independent with and an improved gait. Postoperative CT scans showed complete tumor removal.