Transoral transclival removal of anteriorly placed meningiomas at the foramen magnum

Abstract

Anteriorly placed meningiomas at the level of the foramen magnum are rare, are difficult to diagnose, and present technical problems for a conventional posterior fossa removal. The authors describe the successful transoral transclival excision of two such tumors. Cerebrospinal fluid (CSF) fistula can be avoided by dural repair using a thrombin glue and long term CSF diversion. This modification enables the transoral route to be considered for anteriorly placed intradural lesions.