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Video Abstract

Modified retrosigmoid extended approach to jugular tubercle meningioma: A video abstract

Corresponding author: Sarah A. Basindwah, Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Hawsawi AH, Bawazir M, Basindwah SA, Alqurashi A, Ajlan A. Modified retrosigmoid extended approach to jugular tubercle meningioma: A video abstract. Surg Neurol Int 2022;13:289.



Primary jugular fossa meningiomas are one of the rarest subgroups of meningioma, with an estimated incidence of 0.7–4.3% of all skull base meningiomas. Indeed, only 145 cases of jugular foramen meningiomas have been reported in the literature to date. While meningiomas of this region are typically referred to as “jugular foramen meningiomas,” we make a distinction between meningiomas arising directly from the foramen itself, and those arising from the jugular tubercle. Jugular tubercle meningiomas, therefore, represent an even smaller subset of an already uncommon location for meningiomas. The jugular tubercle is the upper surface of the lateral parts of occipital bone presents an oval eminence, which overlies the hypoglossal canal and is sometimes crossed by an oblique groove for the glossopharyngeal, vagus, and accessory nerves. Only eight cases in the anterior foramen magnum lesions excised by a far lateral retrosigmoid approach have been described. The aim of this video article is to describe the surgical approach the senior author used to access lesion involving the jugular tubercle.

Case Description:

In this surgical video, we present a case of a 56-year-old female presented to our hospital with dizziness, headache, lower cranial nerves deficits, and lower limbs weakness. On exam, she was noted to have a left paraparesis, 9th, 10th, and 11th nerves palsies. An MRI scan demonstrated a mass in the region of the left jugular tubercle. Frozen section was suggestive of meningioma and our patient underwent a successful near total resection with no permanent neurologic sequelae.


Jugular tubercle meningiomas are one of the rarest subgroups of meningioma. The described modified retrosigmoid approach provides outstanding access to the entire ventrolateral brainstem and cerebellopontine angle, with reduced approach related morbidity.


Jugular tubercle
Retrosigmoid approach

[Video 1]-Available on:


  1. 00:00 – Clinical presentation.

  2. 00:29 – preoperative imaging.

  3. 00:51 – Rational, Positioning, and surgical planning.

  4. 01:41 – Procedure video.

  5. 07:54 – Post operative imaging.

  6. 08:21 – surgical outcome and follow up

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.


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