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Falcine meningioma: FEBAIR principles in a "Grade Zero" concept application - 2D operative video
Tamara Brun Vidaletti1, Ana Clara Thibes1, Carlos Eduardo da Silva1
1Department of Neurosurgery, Hospital Ernesto Dornelles, Porto Alegre, Rio Grande do Sul, Brazil.
Background:
Falcine meningiomas account for 5% of intracranial meningiomas. They may involve the eloquent cortex as well as vascular structures. Gross-total resection with additional margins has been shown to be beneficial to patients and has been associated with a reduction in disease recurrence.
Case Description:
A 57-year-old patient presented with recurrent frontal headaches that worsened when lying down. Magnetic resonance imaging showed a large lesion with homogeneous enhancement attached to the anterior third of the falx cerebri at the right frontal lobe, causing significant compression, and suggesting a meningioma.
Conclusion:
This operative video highlights the application of 1st-time, exposure, bone removal, arachnoid, irrigation, and reconstruction principles for safely and effectively removing a large falcine meningioma using the "grade zero" concept for maximal resection.
Insights
This video demonstrates a surgical technique for removing falcine meningiomas, aiming for maximal resection to reduce recurrence. The approach prioritizes patient benefit through safe and effective tumor removal.
Area of Science:
- Neurosurgery
- Oncology
Background:
- Falcine meningiomas represent 5% of intracranial tumors.
- These tumors can affect critical brain areas and blood vessels.
- Complete surgical removal is linked to better patient outcomes and lower recurrence rates.
Observation:
- A 57-year-old patient experienced worsening frontal headaches.
- MRI revealed a large, enhancing lesion on the falx cerebri, compressing brain tissue.
- The lesion was consistent with a falcine meningioma.
Findings:
- The operative video showcases a novel surgical approach for falcine meningioma resection.
- Key principles include exposure, bone removal, arachnoid management, irrigation, and reconstruction.
- The "grade zero" concept facilitates maximal tumor removal.
Implications:
- This technique offers a safe and effective method for resecting large falcine meningiomas.
- Maximal resection is crucial for improving patient prognosis.
- The "grade zero" approach may set a new standard in meningioma surgery.
