|
Transfalcine approach for the resection of a bilateral falx meningioma: Technical nuances and review of literature
Sebastien Boissonneau1, Nathan Beucler2, Thomas Graillon3, Kaissar Farah4, Stephane Fuentes4, Henry Dufour3
1 Neurosurgical Department, Aix-Marseille University, APHM, CHU Timone; Institute of Neurosciences of Systems, INSERM, Toulon, France
2 Sainte-Anne Military Teaching Hospital, Toulon, France
3 Neurosurgical Department, Aix-Marseille University, APHM, CHU Timone, Toulon; CNRS, CRN2M, CHU Timone, Marseille, Aix Marseille University, France
4 Neurosurgical Department, Aix-Marseille University, APHM, CHU Timone, Toulon, France
Correspondence Address:
Dr. Sebastien Boissonneau
Neurosurgical Department, Aix-Marseille University, APHM, CHU Timone; Institute of Neurosciences of Systems, INSERM, Aix Marseille University, Marseille
France
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ajns.AJNS_476_20
|
|
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. |
