The Dural Dark-Side Approach for falcine and tentorial meningioma: A surgical series of five patients
(2022) Neurochirurgie — Vol. 68, n° 1, p. 29-35 (2022)
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- (en) INTRODUCTION: Falcine or tentorial meningioma can be complex to resect. When large meningiomas are located in eloquent areas, a direct ipsilateral surgical approach may cause brain injury and postoperative neurological deficits. In this series, 5 patients were surgically treated using a contralateral transfalcine or transtentorial approach to minimize brain retraction. This strategy was called the Dural Dark-Side Approach (DDSA). The aim was to analyze the quality of tumor resection and postoperative outcome. MATERIAL AND METHODS: In our department, from June 2018 to January 2020, 5 patients underwent microsurgical DDSA for resection of 4 falcine and 1 tentorial meningioma. All tumors were selected on the following two criteria: large>40mm diameter tumor, with surrounding functional cortex. Clinical and radiologic data were retrospectively analyzed. RESULTS AND DISCUSSION: Mean follow-up was 20 months. No patients required use of a rigid retractor during surgery. Gross total resection was performed in 3 patients and near-total resection in 2. All patients had favorable neurologic outcome. Postoperative MRI showed no ipsilateral or contralateral brain lesions. CONCLUSION: This series suggested that meticulous DDSA allows excellent resection in selected large falcine or tentorial meningioma. The approach offered a safe and effective surgical corridor without injuring the surrounding healthy parenchyma.
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Baussart, B., Vanden Bulcke, D., Villa, C., Reina, V., & Gaillard, S. (2022). The Dural Dark-Side Approach for falcine and tentorial meningioma: A surgical series of five patients. Neurochirurgie, 68(1), 29-35. https://doi.org/10.1016/j.neuchi.2021.05.005 (Original work published 2022)