Title : Opalski as a clinical presentation of a foramen magnum meningioma with mass-effect vertebral artery compression: A case report
Abstract:
This is a rare case of a foramen magnum meningioma in a 55-year-old immunocompetent female with no comorbidities who presented with a 2-week history of gradually progressive left-sided weakness with ipsilateral hemisensory loss. The patient initially presented with left shoulder drooping described as heaviness with limited movement of the left upper extremity. A week prior to admission, the patient noted progression of ipsilateral hemiparesis which later involved the left lower extremity associated with gait disturbances. On neurologic examination, noted left shoulder drooping, limited movement of the left upper extremity, poor hand grip on the left, grade 3/5 and ~ 80% sensation. Left lower extremity examination showed no sensory deficits, motor strength of 4/5 and ipsilateral gait ataxia. CT imaging revealed a hyperdense round lesion within the foramen magnum, resulting in a mass-effect significant narrowing of the foramen magnum, compressing the left anterolateral aspect of the medulla and the left vertebral artery.
This case would discuss the patterns of recognizing foramen magnum meningioma, its incidence and how the case mimicked the typical cerebrovascular stroke. Moreover, the case would discuss a cluster of symptoms, namely — ipsilateral hemiparesis, hemiplegia and gait ataxia, also known as Opalski syndrome, from a posterior ischemic infarction by ipsilateral vertebral artery occlusion.
Keywords: Foramen Magnum, Meningioma, Foramen Magnum Meningioma (FMM), Opalski Syndrome.
