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CC BY-NC-ND 4.0 · J Neurol Surg Rep 2021; 82(03): e32-e35
DOI: 10.1055/s-0041-1735905
Case Report

Falx Cerebelli Meningioma: Case Report of a Rarely Occurring Tumor, Management Nuances, and Literature Review

Elizabeth Gallo
1   Department of Neurosurgery, University of Florida, College of Medicine, Jacksonville, Florida, United Sates
,
Grzegorz Brzezicki
1   Department of Neurosurgery, University of Florida, College of Medicine, Jacksonville, Florida, United Sates
,
Raafat Makary
1   Department of Neurosurgery, University of Florida, College of Medicine, Jacksonville, Florida, United Sates
,
Gazanfar Rahmathulla
1   Department of Neurosurgery, University of Florida, College of Medicine, Jacksonville, Florida, United Sates
,
Dinesh Rao
1   Department of Neurosurgery, University of Florida, College of Medicine, Jacksonville, Florida, United Sates
,
Daryoush Tavanaiepour
1   Department of Neurosurgery, University of Florida, College of Medicine, Jacksonville, Florida, United Sates
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Abstract

The falx cerebelli is a small crescent fold of dura mater that is attached to the internal occipital crest and projects forward into the posterior cerebellar notch between the cerebellar hemispheres. We report a rare case of a 61-year-old female who presented with a 1-month history of headache and gait instability. Imaging findings were suggestive of a meningioma arising from the falx cerebelli. Complete surgical resection was achieved with a standard posterior fossa midline approach. Duraplasty was performed using animal allograft dura (Duraguard) and additional layers of oxidized cellulose preparation (Surgicel), fibrin sealant, and nonsuturable collagen matrix (Duragen) were utilized to reduce the risk of a cerebrospinal fluid leak. Pathology confirmed a World Health Organization (WHO) grade-I meningioma. Postoperatively, patient with asymptomatic thrombosis of the left transverse/sigmoid sinuses and later with a pseudomeningocele managed with a lumbar drain. To our knowledge, this is the second documented case in the literature. We discuss intraoperative nuances and unique aspects in the postoperative care and management of these patients.

Keywords

falx cerebelli - meningioma - posterior fossa - pseudomeningocele


Publikationsverlauf

Eingereicht: 03. Oktober 2020

Angenommen: 26. Mai 2021

Artikel online veröffentlicht:
29. September 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Mavridis IN, Lontos K, Anagnostopoulou S. Absent falx cerebelli: report of a rare case. Anat Sci Int 2013; 88 (03) 181-182
    CrossrefPubMedGoogle Scholar
  • 2 Mooney MA, Abolfotoh M, Bi WL. et al. Is falcine meningioma a diffuse disease of the falx? Case series and analysis of a “grade zero” resection. Neurosurgery 2020; 87 (05) 900-909
    CrossrefPubMedGoogle Scholar
  • 3 Panigrahi M, Samiruddin SM, Vooturi S. Crescent durotomy for midline posterior fossa lesions. Neurol India 2019; 67 (01) 155-158
    PubMedGoogle Scholar
  • 4 Smith GA, Strohl MP, Manjila S, Miller JP. Incidence, management, and outcome of symptomatic postoperative posterior fossa pseudomeningocele: a retrospective single-institution experience. Oper Neurosurg (Hagerstown) 2016; 12 (03) 298-304
    CrossrefPubMedGoogle Scholar
  • 5 Javalkar V, Banerjee AD, Nanda A. Posterior cranial fossa meningiomas. Skull Base 2012; 73 (Suppl. 01) 1-10
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 6 Agrawal A. Falx cerebelli meningioma: technical note. Romanian Neurosurgery 2014; 21 (03) 337-340
    CrossrefPubMedGoogle Scholar
  • 7 Ito M, Kamiyama H, Nakamura T, Nakajima H, Tokugawa J. Dural cavernous hemangioma of the cerebellar falx. Neurol Med Chir (Tokyo) 2009; 49 (09) 410-412
    CrossrefPubMedGoogle Scholar
  • 8 Shin HS, Choi DS, Baek HJ. et al. The oblique occipital sinus: anatomical study using bone subtraction 3D CT venography. Surg Radiol Anat 2017; 39 (06) 619-628
    CrossrefPubMedGoogle Scholar
  • 9 Candanedo C, Moscovici S, Kaye AH, Spektor S. The oblique occipital sinus - implications in posterior fossa approaches. J Clin Neurosci 2020; 76: 202-204
    CrossrefPubMedGoogle Scholar
  • 10 Hamnett NTJ, Ogungbo B, Nahser H, Javadpour M. Anomalous cerebral venous sinus drainage. Br J Neurosurg 2010; 24 (04) 497-498
    CrossrefPubMedGoogle Scholar
  • 11 Abou-Al-Shaar H, Gozal YM, Alzhrani G, Karsy M, Shelton C, Couldwell WT. Cerebral venous sinus thrombosis after vestibular schwannoma surgery: a call for evidence-based management guidelines. Neurosurg Focus 2018; 45 (01) E4
    CrossrefPubMedGoogle Scholar
  • 12 Zhao Y, Chen L, Zhang J. et al. Duraplasty with cervical fascia autograft to reduce postoperative complications of posterior fossa tumor surgery with suboccipital midline approach. World Neurosurg 2020; 134: e1115-e1120
    CrossrefPubMedGoogle Scholar
  • 13 Orlev A, Jackson CM, Luksik A. et al. Natural history of untreated transverse/sigmoid sinus thrombosis following posterior fossa surgery: case series and literature review. Oper Neurosurg (Hagerstown) 2020; 19 (02) 109-116
    CrossrefPubMedGoogle Scholar
  • 14 Benjamin CG, Sen RD, Golfinos JG. et al. Postoperative cerebral venous sinus thrombosis in the setting of surgery adjacent to the major dural venous sinuses. J Neurosurg 2018; 131 (04) 1-7
    CrossrefPubMedGoogle Scholar
  • 15 Apra C, Kotbi O, Turc G. et al. Presentation and management of lateral sinus thrombosis following posterior fossa surgery. J Neurosurg 2017; 126 (01) 8-16
    CrossrefPubMedGoogle Scholar
  • 16 Higgins JN, Macfarlane R, Axon PR. et al. Headache, cerebrospinal fluid leaks, and pseudomeningoceles after resection of vestibular schwannomas: efficacy of venous sinus stenting suggests cranial venous outflow compromise as a unifying pathophysiological mechanism. J Neurol Surg B Skull Base 2019; 80 (06) 640-647
    Artikel in Thieme ConnectPubMedGoogle Scholar