Intradural C-1 ventral root schwannomas treated by surgical resection via the lateral suboccipital transcondylar approach--three case reports

Three female patients aged 50-79 years (mean 61.0 years) presented with extremely rare intradural C-1 root schwannoma manifesting as foramen magnum syndrome. Magnetic resonance imaging revealed the intradural extra-axial tumors extending from the anterior aspect of the medullospinal junction, with a mean major diameter of 2.7 cm. Total resection of the tumors was performed via the lateral suboccipital transcondylar approach after a mean period of 11.7 months from the symptom onset. The final diagnosis of schwannoma of the C-1 ventral root was based on the intraoperative and histological findings. All three patients were successfully rehabilitated, with symptomatic improvement and no evidence of tumor recurrence. All three patients were successfully treated by surgical resection via the lateral suboccipital transcondylar approach. This approach is effective and safe provided individual anatomy, drilling of the occipital condyle, and patient position are considered carefully.