{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T15:55:43Z","timestamp":1792166143575,"version":"4.4.0"},"reference-count":80,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>This study aimed to evaluate neurological function and progression\/recurrence (P\/R) outcome of foramen magnum meningioma (FMM) based on a modified classification.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>This study included 185 consecutive patients harboring FMMs (mean age 49.4 years; 124 females). The authors classified the FMMs into 4 types according to the previous classification of Bruneau and George as follows: Type A (n = 49, 26.5%), the dural attachment of the lesion grows below the vertebral artery (VA); Type B (n = 39, 21.1%), the dural attachment of the lesion grows above the VA; Type C1 (n = 84, 45.4%), the VA courses across the lesion with or without VA encasement or large lesions grow both above and below the bilateral VA; and Type C2 (n = 13, 7.0%), Type C1 plus partial\/total encasement of the VA and extradural growth.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The median preoperative Karnofsky Performance Scale (KPS) score was 80. Gross-total resection (GTR) was achieved in 154 patients (83.2%). Lower cranial nerve morbidity was lowest in Type A lesions (16.3%). Type C2 lesions were inherently larger (p = 0.001), had a greater percentage of ventrolateral location (p = 0.009) and VA encasement (p &lt; 0.001), lower GTR rate (p &lt; 0.001), longer surgical duration (p = 0.015), higher morbidity (38.5%), higher P\/R rate (30.8%, p = 0.009), and poorer recent KPS score compared with other types. After a mean follow-up duration of 110.3 months, the most recent follow-up data were obtained in 163 patients (88.1%). P\/R was observed in 13 patients (7.2%). The median follow-up KPS score was 90. Compared with preoperative status, recent neurological status was improved in 91 (49.2%), stabilized in 76 (41.1%), and worsened in 18 (9.7%) patients. The multivariate Cox proportional hazard regression model demonstrated Type C2 (HR 3.94, 95% CI 1.04\u201315.0, p = 0.044), nontotal resection (HR 6.30, 95% CI 1.91\u201320.8, p = 0.003), and pathological mitosis (HR 7.11, 95% CI 1.96\u201325.8, p = 0.003) as independent adverse predictors for tumor P\/R. Multivariate logistic regression analysis identified nontotal resection (OR 4.06, 95% CI 1.16\u201314.2, p = 0.029) and pathological mitosis (OR 6.29, 95% CI 1.47\u201327.0, p = 0.013) as independent risks for poor outcome (KPS score &lt; 80).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>The modified classification helped to predict surgical outcome and P\/R in addition to the position of the lower cranial nerves. Preoperative imaging studies and neurological function should be reviewed carefully to establish an individualized management strategy to improve long-term outcome.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2016.2.jns152873","type":"journal-article","created":{"date-parts":[[2016,5,13]],"date-time":"2016-05-13T15:01:36Z","timestamp":1463151696000},"page":"661-676","source":"Crossref","is-referenced-by-count":20,"title":["Foramen magnum meningiomas: surgical results and risks predicting poor outcomes based on a modified classification"],"prefix":"10.3171","volume":"126","author":[{"given":"Da","family":"Li","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China;"},{"name":"China National Clinical Research Center for Neurological Diseases;"},{"name":"Center of Brain Tumor, Beijing Institute for Brain Disorders; and"},{"name":"Beijing Key Laboratory of Brain Tumor, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China;"},{"name":"China National Clinical Research Center for Neurological Diseases;"},{"name":"Center of Brain Tumor, Beijing Institute for Brain Disorders; 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