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Journal of Clinical and Applied Neurosciences                            Volume 2; Issue 1                                   Jan-Jun 2017
CASE REPORT
Foramen Magnum Meningioma Misdiagnosed as Cervical Spondylosis
Chika A NDUBUISI, Linda U Iroegbu EMERUEM, Wilfred C MEZUE,
Kelechi O NDUKUBA

AFFILIATION
Department of Neurosurgery
Memfys Hospital for Neurosurgery Enugu NIGERIA

CORRESPONDING
AUTHOR
Chika A NDUBUISI
Department of Neurosurgery
Memfys Hospital for Neurosurgery PO Box 2292 Enugu, NIGERIA

E-mail: chikandu@yahoo.com
Phone: +234 803 436 0540

DISCLOSURES: There was no disclosure to be made

Received: 5th June, 2017
Accepted: 25th June, 2017
ABSTRACT

Anterior foramen magnum (FM) meningiomas are uncommon tumours. The diagnosis may be missed if not properly investigated. We report a 54-year old female referred for decompressive surgery following cervical spine MRI report of degenerative spine disease. She presented with an 18-month history of neck pain, a 12-month history of quadriparesis and dysphagia. Examination revealed multiple lower cranial nerve palsies, grade 2/5 quadriparesis, C3 sensory level and upper motor neuron signs. Plain cervical spine radiography done before presentation showed degenerative changes. The FM lesion was also missed on non-contrast cervical spine magnetic resonance imaging (MRI) done prior to presentation. Post-contrast enhanced brain MRI done at admission, however, revealed uniformly enhancing tumour located anterior to the ponto-medullary junction and extending through the foramen magnum to the atlas, on the midline. Post-excision histopathological studies confirmed fibroblastic meningioma. This case highlights the importance of proper matching of clinical history, neurological evaluation, anatomical localization of lesions and appropriate neuro-radiological investigations to aid diagnosis.

Keywords: C
ervical degenerative disease, contrast MRI, misdiagnosis, quadriparesis, rare