AIM We aimed to show the significance of the anterior pontine membrane as a determining structure between the subdural and subarachnoid space in the clival region. MATERIAL AND METHODS Five adult cadaver heads and five cerebral hemispheres were used. The skull vault and hemipheres were removed by sectioning through the pontomesencephalic junction. Five other heads hemispheres were removed but...

BACKGROUND Clival chordomas are a rare type of cancer with low metastatic potential and primary metastasize to the lung or bones. CASE DESCRIPTION This case report describes a possible metastatic, paravertebral chordoma at level C4-C5 in a patient with a past medical history of a clival chordoma. CONCLUSION Chordomas are unpredictable and may metastasise.

Chordomas in the clival-cervical region present challenges to the neurosurgical team due to their encroaching nature, proximity to critical neurovascular structures and often large size due to late presentation. This report illustrates the utility of a staged approach when confronted with such a pervasive tumour. We describe the adaptive combination of two approaches, the endoscopic endonasal t...

The best treatment for clival chordoma is obtained with total surgical excision, sometimes combined with adjuvant radiotherapy. A cerebrospinal fluid (CSF) fistula is a fatal complication that may occur following extended transsphenoidal surgery (TSS) and adjuvant radiotherapy. We report a case of fulminant meningitis without a CSF fistula in a 57-year-old woman who underwent TSS and multiple r...

Background. Purely ectopic pituitary adenomas are exceedingly rare. Here we report on a patient that presented with an incidental clival mass thought to be a chordoma. Endonasal resection, tumor pathology, and endocrinology workup revealed a prolactinoma. Case Presentation. A 41-year-old male presented with an incidental clival lesion presumed to be a chordoma. On MRI it involved the entire cli...

BACKGROUND A few cases depicting apoplexy in a chordoma have been reported. Rarely, this intratumoral bleed may spillover into intracerebral or intraventricular regions. CASE DESCRIPTION The authors report an intradural variety of clival chordoma presenting with apoplexy and spillover of blood into lateral ventricle. Clinical presentation, radiological scans, and relevant literature is also d...

Lesions of the lower clivus represent a technically challenging subset of skull base disease that requires careful treatment. A 75-year-old woman with tongue atrophy was referred for resection of a presumed clival chordoma. The lesion was resected via an endoscopic transnasal transclival approach with no complications. Pathology revealed only chronic inflammatory tissue consistent with a degene...

Clival chordomas confront the surgeon with the task of resecting an aggressively invasive and destructive tumor in a critical surrounding. For many, mainly smaller, chordomas, the transnasal transclival approach is a feasible and safe surgical access. Larger tumors and especially those with extensive intradural, retrochiasmal, and/or deep cervical expansion are mostly approached by open craniot...