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A great Y -shape dural starting had been accomplished and a couple meningiomas had been resected with the classical four Deb methods (devascularize, remove, debulking, and dissect). Almost all biological constructions ended up respected there weren't any modifications from neuromonitoring. Individual has been dismissed soon after 10 days inside excellent neurological condition this website . Conclusion  a solitary way of several meningiomas of the craniovertebral 4 way stop along with top cervical spine area is achievable and efficient. Videofluoroangiography in an effort to attain much better creation as well as charge of the particular vertebral artery, and also neurophysiological keeping track of are crucial resources to reduce the deaths with this surgery concern. The url to the online video is available in https//youtu.be/4w9HCfQZkgg .Targets  Safe optimum resection could be the concept involving cranial bottom surgery and also the level regarding resection is a issue having an influence on the prognostic result. This specific key video clip features your surgical ideas and also specialized intricacies within the microsurgical resection associated with foramen magnum meningioma (FMM). Case Outline  The medical procedures has been carried out in a 45-year-old girl which assigned hoarseness involving voice and also spastic quadriparesis (level 4/5). About image resolution, FMM with bulk effect on brainstem and also spinal-cord had been discovered. The tumour had been gross absolutely resected by means of revised much lateral tactic with small occipital condyle exploration. This particular online video illustrates the particular medical methods of tumour resection which include first devascularization, functioning from the arachnoid aircraft in order to dissect your neurovascular buildings, piecemeal decompression, sharpened dissection to part ways cancer via reduce cranial nervous feelings (LCN), identifying the brainstem blood vessels, as well as resecting your sore coming from tumor-brainstem software. Postoperatively, she'd important neural advancement and also the permanent magnet resonance photo unveiled exceptional radiological outcome ( Figs. 1 and a pair of ). Summary  The surgical treatment involving FMM will be challenging because of the deep surgical arena, vital location, close proximity with many neurovascular constructions, company persistence, and also vascularity in the cancer. The modified far side to side method by simply preserving the particular occipital condyle can prevent the actual postoperative incidence regarding craniovertebral junction uncertainty. The main element surgical concepts to offer the best operative result incorporate mindful dissection across the arachnoid airplane, soft managing involving cranial nerves, veins, and also perforator vessels, deterrence associated with footing on brainstem and also spinal-cord, intraoperative neurophysiological overseeing, suitable hemostasis, and also painstaking dural end. The link to the online video is available at https//youtu.be/1qvAeUmNIUw .Surgery accessibility to the ventral foramen magnum continues to be any technological problem. Along with large skin lesions in this field contracting the brainstem and muffling the localised neurovascular associations, making the surgery strategy and it is appropriate setup possess vital value throughout accomplishing advantageous results.