142
existing cranial nerve deficits [ 22 ]. Lower cranial
nerve palsies are the most commonly observed
postoperative deficit, although these deficits
(unlike those present preoperatively) have a ten-
dency to recover with time [ 1 – 3 ]. Dysphagia with
an attendant risk of aspiration pneumonia may be
seen in up to 10% of patients. Multiple regression
analysis identified tumor recurrence, arachnoid
scarring, prevalent cranial extension, and absence
of preoperative lower CN dysfunction as signifi-
cantly associated with aspiration pneumonia
[ 18 ]. Vigilance is required postoperatively to
minimize these risks.
Conclusions
Foramen magnum meningiomas are a rare entity
with the potential for significant symptoms pre-
operatively and significant complications postop-
eratively. Thorough preoperative imaging and
evaluation aids in determining the extent of neu-
rovascular involvement and in detailing the bony
anatomy in the region of the tumor. With ade-
quate surgeon experience and selection of the
optimal surgical approach, successful extirpation
of the tumor may be achieved.
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