The link to your deep genetic divergences movie can be located at https//youtu.be/AIGebJPJEnw .Objectives  We present a challenging case of a 61-year-old male client with a double meningioma. 1st one was located in the right-side of foramen magnum plus the 2nd one was situated on remaining anterolateral side of C1-C2. Background  Patient referred at our establishment for a progressive spastic paraparesis from around 1 year with a current start of numbness in right hand. Neuroradiological imaging revealed an extra-axial enhancing cyst with a dural end in the right edge of foramen magnum and another contralateral extra-axial improving lesion at C1-C2 amount ( Fig. 1 ). Outcomes  we plumped for a park workbench position. Neurophysiological tracking had been made use of during both placement and surgery. A linear skin incision into the occipital region extended to C7 was performed and a suboccipital craniotomy because of the laminectomy of C1-C3 was performed ( Fig. 2 ). Videofluroangiography ended up being done to the most useful visualization of the vertebral artery place during microsurgical dissection and publicity of craniovertebral junction region. An Y -shape dural opening was executed and two meningiomas had been resected using the traditional four D steps (devascularize, detach, debulking, and dissect). All anatomical frameworks had been respected and there were no modifications at neuromonitoring. Patient ended up being discharged after 10 times in great neurological problem. Conclusion  just one method for several meningiomas for the craniovertebral junction and top cervical spine region is feasible and effective. Videofluoroangiography as a way to achieve better visualization and control of the vertebral artery, and neurophysiological monitoring are very important tools to lessen the morbidity for this medical challenge. The link to the movie can be obtained at https//youtu.be/4w9HCfQZkgg .Objectives  Safe maximum resection may be the standard concept of cranial base surgery and also the quality of resection is a vital aspect influencing the prognostic outcome. This operative video clip features the surgical axioms and technical nuances into the microsurgical resection of foramen magnum meningioma (FMM). Case Description  The surgery was performed in a 45-year-old woman whom given hoarseness of sound and spastic quadriparesis (class 4/5). On imaging, FMM with mass effect on brainstem and spinal cord ended up being identified. The cyst ended up being gross completely resected through changed far horizontal method with reduced occipital condyle drilling. This video demonstrates the medical methods of tumor resection including very early devascularization, operating in the arachnoid jet to dissect the neurovascular frameworks, piecemeal decompression, sharp dissection to split up cyst from reduced cranial nerves (LCN), identifying the brainstem veins, and resecting the lesion from tumor-brainstem user interface. Postoperatively, she had considerable neurological enhancement as well as the magnetized resonance imaging revealed exemplary radiological outcome ( Figs. 1 and 2 ). Conclusion  The surgery of FMM is challenging as a result of the deep surgical corridor, vital area, close distance with various neurovascular frameworks, fast consistency, and large vascularity associated with tumor. The modified far lateral approach by keeping the occipital condyle may avoid the postoperative occurrence of craniovertebral junction uncertainty. The main element operative axioms to achieve the most useful surgical result include mindful dissection across the arachnoid plane, mild handling of cranial nerves, veins, and perforator vessels, avoidance of grip on brainstem and spinal-cord, intraoperative neurophysiological tracking, proper hemostasis, and careful dural closure. The link into the movie can be bought at https//youtu.be/1qvAeUmNIUw .Surgical accessibility the ventral foramen magnum stays a technical challenge. With huge lesions in this region compressing the brainstem and distorting the local neurovascular connections, formulating a surgical program and its own appropriate execution have actually important relevance in achieving favorable outcomes. Even though the endoscopic endonasal techniques DNA inhibitor have actually gained increasing attention to accessibility the clivus and also the ventral brainstem, foramen magnum meningiomas are favored become removed via an approach that obviates a trajectory through the nasopharyngeal mucosa. Therefore, the far lateral approach stays very useful methods of these challenging lesions. This operative video clip shows the usage of the far lateral transcondylar transtubercular strategy to eliminate a large meningioma into the ventral foramen magnum in a 63-year-old male with progressive cervical myelopathy, showing as spastic quadriparesis without the cranial nerve problem. Utilizing a right-sided far lateral transcondylar t are found at https//youtu.be/s1dFhuaRSt8 .Basilar invagination is a congenital or acquired craniovertebral junction abnormality where tip regarding the odontoid process projects through the foramen magnum which can trigger severe immune gene symptomatic compression associated with brainstem and spinal-cord. If left untreated, patients could form progressive quadriparesis. Typically, basilar invagination can usually be treated with cervical traction and posterior stabilization. Nonetheless, in irreducible situations, anterior decompression via a transoral or endonasal method is essential.