Falx Meningioma

Michael Norman Jusman*, Suzy Indharty**, Abdul Gofar Sastrodiningrat***Department of Neurosurgery

Adam Malik General Hospital – University of Sumatra Utara

Abstract:

Background:

Falx meningioma comprise of 11.9% in a meningioma series according to its prevalent location among other type of meningioma. The challenge of surgery in falx associated with preservation of sensory-motor deficits and avoiding iatrogenic venous infarction. The following case report will review a falx meningioma surgery in our centre, which performed with limited facilities.

Methods:

30 years old male present with right leg monoparesis 4 months before admission. A month ago, he experienced general seizure which resolve spontaneously without antiseizure medication. Slight to moderate headache accompanying this symptoms since a year before admission. The CT scan revealed isodense mass lesion which lies on falx area. The MRI Brain with gadolinium contrast injection shows a solitary homogenous well-enhanced mass lesion in falx cerebri which denotes falx meningioma. MR Angiography was made pre-operatively to learn draining cortical veins into dural sinus. Dexamethasone in tapering fashioned was given before surgery and we did Simpson’s Grade II Tumor removal with superior sagittal sinus preservation.

Result:

The patient experience slight numbness and monoparesis within a week post operatively, followed by improvement in motor strength and seizure was controlled by phenytoin medication. The histopathologic studies found whore like appearance correspond to a meningothelial type of meningioma

Conclusion:

Preservation of dural sinus and adjacent eloquent area are a key success in falx meningioma surgery. An Appropriate position and slight brain retraction are mandatory to achieve this goal.

Keywords: Superior Sagittal Sinus, Eloquent area, Simpson’s tumor removal grading