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CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(04): 821-823
DOI: 10.4103/ajns.AJNS_476_20
Technical Note

Transfalcine approach for the resection of a bilateral falx meningioma: Technical nuances and review of literature

Sebastien Boissonneau
1   Neurosurgical Department, Aix-Marseille University, APHM, CHU Timone, Toulon
2   Institute of Neurosciences of Systems, INSERM, Toulon
,
Nathan Beucler
3   Sainte-Anne Military Teaching Hospital, Toulon
,
Thomas Graillon
1   Neurosurgical Department, Aix-Marseille University, APHM, CHU Timone, Toulon
4   CNRS, CRN2M, CHU Timone, Marseille, Aix Marseille University
,
Kaissar Farah
1   Neurosurgical Department, Aix-Marseille University, APHM, CHU Timone, Toulon
,
Stephane Fuentes
1   Neurosurgical Department, Aix-Marseille University, APHM, CHU Timone, Toulon
,
Henry Dufour
1   Neurosurgical Department, Aix-Marseille University, APHM, CHU Timone, Toulon
4   CNRS, CRN2M, CHU Timone, Marseille, Aix Marseille University
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The tendency to reduce invasive surgeries is gaining more adepts, and the primary goal in meningioma surgery is the maximal safe resection. Falx meningioma is common location for intracranial meningioma, and according to their deep localization, falx meningioma represents a neurosurgical challenge. The objective of the study is to report the feasibility of a transfalcine nontumor dominant side approach for a bilateral falx meningioma. We report a technical note about the surgical approach of a 44-year-old female suffering from an evolutive meningioma of the middle third of the falx. According to the venous drainage anatomy, and the tumor conformation, a contralateral transfalcine approach was done. We described with details this surgical approach, and a reflection about transfalcine approach is proposed, which is a variant of the interhemispheric approach. It permits a good exposure of the medial surface of the contralateral hemisphere thanks to a falx incision. Moreover, a literature review is proposed about 278 articles with a special emphasis on transfalcine approach in meningioma surgery. We report an original minimal invasive approach for an intracranial meningioma, with a complete resection (Simpson I) without any technical complication. This contralateral transfalcine approach brings new technical nuances for the resection of falx or midline intracranial tumors.

Key-words:

Meningioma - minimal invasive surgery - nontumor dominant side approach - transfalcine approach

Financial support and sponsorship

Nil.




Publication History

Received: 20 October 2020

Accepted: 13 May 2021

Article published online:
16 August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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