title: Foramen magnum meningiomas: surgical treatment in a single public institution in a developing country.
abstract: OBJECTIVE
  To analyze the clinical outcome of patients with foramen magnum (FM) meningiomas.
  
  
  METHODS
  Thirteen patients (11 Feminine / 2 Masculine with FM meningiomas operated on through lateral suboccipital approach were studied. Clinical outcome were analyzed using survival (SC) and recurrence-free survival curves (RFSC).
  
  
  RESULTS
  All tumors were World Health Organization grade I. Total, subtotal and partial resections were acchieved in 69.2%, 23.1% and 7.7%, respectively, and SC was better for males and RFSC for females. Tumor location, extent of resection and involvement of vertebral artery/lower cranial nerves did not influence SC and RFSC. Recurrence rate was 7.7%. Operative mortality was 0. Main complications were transient (38.5%) and permanent (7.7%) lower cranial nerve deficits, cerebrospinal fluid fistula (30.8%), and transient and permanent respiratory difficulties in 7.7% each.
  
  
  CONCLUSIONS
  FM meningiomas can be adequately treated in public hospitals in developing countries if a multidisciplinary team is available for managing postoperative lower cranial nerve deficits.
authors: Divisão de Neurocirurgia, Departamento de Cirurgia e Anatomia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirao Preto, SP, Brazil.
authors: Benedicto Oscar
authors: BO
authors: Colli
authors: Divisão de Neurocirurgia, Departamento de Cirurgia e Anatomia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirao Preto, SP, Brazil.
authors: Carlos Gilberto
authors: CG
authors: Carlotti-Junior
authors: Divisão de Neurocirurgia, Departamento de Cirurgia e Anatomia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirao Preto, SP, Brazil.
authors: João Alberto
authors: JA
authors: Assirati-Junior
authors: Universidade do Paraná, Curitiba, PR, Brazil.
authors: Luis Alencar Biurrum
authors: LA
authors: Borba
authors: Divisão de Neurocirurgia, Departamento de Cirurgia e Anatomia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirao Preto, SP, Brazil.
authors: Vicente de Paulo Martins
authors: Vde P
authors: Coelho-Junior
authors: Departamento de Patologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirao Preto, SP, Brazil.
authors: Luciano
authors: L
authors: Neder
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil; D005260:Female; D005500:Follow-Up Studies; D005539:Foramen Magnum / Q000473:pathology / Q000601:surgery*; D006779:Hospitals, Public; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome