[Dynamics of caudal cranial nerves' functions after resection of ventrolateral craniovertebral meningioma: clinical case and literature review].

Abstract

Surgery of meningiomas of the craniocervical region is one of the most difficult parts of neurosurgery due to the closeness of the brainstem, caudal group of the cranial nerves (CNs) and vertebral artery. According to the literature, suffering of the caudal group of CNs is between 20 and 55% according to different authors. In their dysfunction, the recovery of CNs is long-term and requires joint efforts by both the medical team and the patient and his family.

Objective: To demonstrate the dynamics of the restoration of CNs functions (over 12 years) in patient after resection of the ventrolateral craniocervical meningioma.

Material and methods: The article describes a clinical case of patient with ventrolateral meningioma of the craniocervical region. The tumor was resected (Simpson II) from a posterolateral access with transcondylar extension.

Results: The dynamics of caudal CNs recovery over 12 years has been traced and presented. In this clinical case, the main restoration of caudal CNs function has been observed during the first 6 months after surgery and remained unchanged thereafter.

Conclusion: Based on the literature data and presented clinical observation, it appears that the resection of meningiomas from the lower third of the clivus is predictably associated with a high risk of caudal CNs dysfunction, that should be considered when planning an operation and a postoperative rehabilitation program.