Stereotactic radiosurgery for anterior foramen magnum meningiomas

Surg Neurol. 1999 Mar;51(3):268-73. doi: 10.1016/s0090-3019(98)00099-8.


Background: Total microsurgical resection is the procedure of choice for growing and symptomatic foramen magnum meningiomas. We hypothesized that for patients with advanced age, complicating medical conditions, or residual or recurrent meningiomas at the foramen magnum, stereotactic radiosurgery would be a useful adjunctive (n = 2) or alternative (n = 3) treatment.

Methods: We report our experience in five elderly patients (73-84 years) who underwent gamma knife radiosurgery. The median tumor volume was 10.5 ml and the tumor margin dose varied from 10 to 16 Gy. Because of the irregular tumor volumes along the inferior clivus, multiple isocenters of irradiation were required (range, 2-8; mean 4.4).

Results: During the follow-up interval of 1-5 years (median, 3 years), one patient died of an intercurrent illness, and all remaining patients were stable without any further deterioration in their clinical condition. Follow-up imaging studies revealed a reduction in tumor volume in one patient and no further growth in the remaining four.

Conclusion: We believe that stereotactic radiosurgery provides safe and effective management for patients who are poor candidates for resection of their foramen magnum meningiomas.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Foramen Magnum
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Meningeal Neoplasms / diagnosis
  • Meningeal Neoplasms / surgery*
  • Meningioma / diagnosis
  • Meningioma / surgery*
  • Middle Aged
  • Radiosurgery*
  • Tomography, X-Ray Computed