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Abstract We concluded that: -Lesions at the craniocervical junction can present with a wide constellation of neurological signs and symptoms, and false localizing signs are numerous. -Posterior median suboccipital approach was the best choice for the selected cases. -The outcome has no significant correlation with the operative approach, several factors contribute to the outcome, including: • Surgeon’s experience. • Patient factors: age, co-morbid diseases. Lesion factors: vascularity, relation to adjacent structures, consistency. Good anesthesia: adequate brain relaxation, adequate hypotensive anesthesia. Intra operative facilities: operative microscope, micro-instruments. |