RETRO ODONTOID MENINGIOMA - A Rare Case report

Abstract

We are presenting a rare case of retroodontoid
meningioma. 46year old female
presented with slowly progressive weakness
of the right lower limb, followed by
the right upper limb and then the left upper
limb for a duration of 6 months. No
other significant history. On examination,
patient had quadriparesis with spasticity
involving all 4 limbs and Grade 4 Power
in Right lower and upper extremity , with
exaggerated reflexes, more on the right.
Babinskis sign was positive on both
sides and the breath count was 15
breaths per minute. There was blunted
proprioception on the Right toes and
Rhomberg's sign was negative. Pain and
temperature sensations were reduced on
Right lower limbs .Lower cranial nerves
and cerebellum were intact. MRI showed
an extraaxial tumour extending craniocaudally
from above the anterior lip of
the foramen magnum to the base of the
dens and transversely occupying right
anterolateral position with respect to the
cord, its dimensions were 4 x 3 x 2cm.A
diagnosis of Spinocranial variety of Ventral
foramen magnum meningioma (Retro-
Odontoid type) was arrived at.Treatment
Through a right posterolateral approach
Suboccipital craniectomy with C1, C2 and
C3 laminectomy was made with the preservation
of the occipital condyle , Complete
microsurgical excision of the tumor
was achieved . Patient was discharged on
12 th post operative day without any complication.
Reference regarding similar
cases in literature was made. Conclusions
. Retro-odontoid meningiomas are
very rare tumors, and should be included
in the differential diagnosis for high cervical
cord compression in foramen magnum
region. The understanding of the normal
and pathological anatomy is of foremost
importance. The microsurgical technique
is a must in dissection of these tumors.