Combined supracerebellar infratentorial and right occipital interhemispheric approach to falcotentorial junction meningioma: A case report

Abstract

Background: Falcotentorial meningioma is a rare tumor of pineal region, arising from the dural folds where the tentorium and falx meet. Due to the deep location and near closeness to significant neurovascular structures, gross-total tumor resection in this area can be complicated. Pineal meningiomas can be resected using a variety of approaches; however, all these approaches are associated with a significant risk of postoperative complications. Case Description: A 50-year-old female patient who presented with several headaches and visual field defect and diagnosed with pineal region tumor is discussed in the case report. Patient was successfully managed surgically by combined supracerebellar infratentorial and right occipital interhemispheric approach. Cerebrospinal fluid circulation was restored after surgery and neurological defects were regressed. Conclusion: Our case shows that it is possible to completely remove giant falcotentorial meningiomas with minimal brain retraction, preserve the straight sinus and vein of Galen, and prevent neurological impairments by combining two approaches.

Falcotentorial Meningiomas: Insights from Surgical Strategies and Clinical Outcomes

“…Staged surgery was not performed in our patients, and residual tumors were treated by means of radiotherapy. The combination of both approaches was reported for the resection of a large falcotentorial meningioma with minimal brain retraction, preservation of the vein of Galen and straight sinus, and no postoperative neurological deficits [29]. The most common complication associated with the supracerebellar infratentorial approach is the risk of air embolism in patients operated in a semi-seated position.…”

Technique notes on the management of superior sagittal or transverse sinus during the falcotentorial meningioma surgery: a case report

“…Intraoperative bleeding and damage to the surrounding vasculature are also common concerns. Additionally, due to their proximity to the tentorium and the complexities involved in achieving adequate surgical exposure while minimizing trauma to surrounding structures, complete tumor removal can be difficult to achieve without compensating crucial neurological function ( 3 , 4 ). Close monitoring of patient's neurological status during surgery is essential to detect any potential complications early on and prevent long-term disabilities.…”