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
