Falx meningioma of the anterior third treatment

Falx meningioma of the anterior third are the simplest to handle, because they are situated in a region where the superior sagittal sinus can be sacrificed if necessary in order to achieve their total removal.

The surgeon can be relatively aggressive with excision of the lateral walls of the longitudinal sinus and compromised falx because the whole dural venous sinus can be ligated in this area, with minimal neurological complications, even if it is patent. If the entire sinus is occluded and the falx is infiltrated, then an incision is developed in the dura on the contralateral side and the involved sinus and subadjacent infiltrated falx are excised in one segment. In such situations, the anterior and posterior aspects of the sinus are closed with stay sutures, passed through the falx beneath the inferior corner of the sinus, before excision of the sinus and residual meningioma.

In the anterior third type of tumor, it was usually possible to take draining veins and the sagittal sinus, if required, to complete resection ¹⁾