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The Contralateral Transfalcine Approach: An Anatomic Study Quantifying Its Superior and Lateral Limits of Exposure
A Yohan Alexander1,2,3, Stephen Graepel2, Maria Peris-Celda1,2,4
1Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Mayo Clinic, Rochester, Minnesota, USA.
Operative Neurosurgery (Hagerstown, Md.)
|May 21, 2026
Summary
The contralateral transfalcine approach offers limited superior exposure, decreasing posteriorly from 4.8 mm to 12.6 mm from the cortex. Deeper visualization within the interhemispheric corridor improves contralateral exposure.
Area of Science:
- Neurosurgery
- Anatomy
- Surgical Approaches
Background:
- Contralateral transfalcine approaches are standard for interhemispheric pathologies.
- The maximal superior exposure limit via this approach remains undefined.
Purpose of the Study:
- To anatomically define the superior and lateral limits of contralateral exposure using the transfalcine approach.
Main Methods:
- Performed transfalcine approaches in 10 cadaveric heads across anterior, middle, and posterior thirds.
- Measured maximal superior and lateral visualization limits of the contralateral hemisphere.
Main Results:
- Superior visualization limit decreased posteriorly (4.8 mm anteriorly to 12.6 mm posteriorly).
- Lateral visualization at the corpus callosum ranged from 21.3 mm to 22.9 mm.
Conclusions:
- Superior contralateral exposure decreases posteriorly along the interhemispheric corridor.
- Deeper visualization enhances contralateral exposure within the interhemispheric corridor.