NOTE! This site uses cookies and similar technologies.

If you not change browser settings, you agree to it. Learn more

I understand

In order to make our website more comfortable and intuitive, we use cookies: they are small files of information needed to understand how users navigate in our website and make your browsing experience more enjoyable and more efficient in the future. Cookies do not store any personal information, and will not be stored any identifiable data. If you want to disable the use of cookies you have to customize the settings of your internet browser by removing all existing cookies and disabling their storage. To proceed without modifying the application of the cookies just continue the surfing.

Please visit for more information about cookies and how they affect your browsing experience.

Types of cookies used:

Technical cookie 
These cookies are essential for the website navigation; without some of these, technical issues could not work.

Performance cookie
These cookies collect informations about how visitors use the website: for example, which pages are most popular, and which pages have reported warnings or error messages. These cookies do not collect any personal information about the visitor, and they are used only to improve the website operation. By using our website, you agree that these cookies may be installed on your device.

Functionality Cookie
Cookies allow the website to remember the choices made by the user (for example, to remember the language choice) and provide custom functionality. These cookies can also be used to remember changes to the text size and other features of web pages that you can customize. They can also be used to provide services such as watching a video or sharing on social networks. The information gathered from these types of cookies can be anonymous and can't track your browsing activity on other websites. By using our website, you agree that these cookies may be installed on your device.

Google Analytics
This website uses Google Analytics, a web analytics service provided by Google Inc.
The information generated by the cookie about your use of the website (including your anonymous IP address) will be transmitted and stored in Google's servers in the United States. Google will use this information with the purpose of evaluating your use of the website, compiling reports on website activity for the operators and providing other services relating to website activity and internet usage. Google may also transfer this information to third parties, unless required by law, or where such third parties process the information on Google's behalf. Google will not associate your IP address with any other data held by Google. By using this website, you allow Google to process the data about you in the manner and purposes set out above.

This website uses plugins from the social network, which is operated by Facebook Inc., 1601 S. California Ave, Palo Alto, CA 94304, USA (subsequently called "Facebook"). When opening a website that contains such a plugin, your browser will establish a direct connection to the Facebook servers. Facebook will transfer the content of the plugin directly to your browser, the latter of which will embed it in the website. This website hence does not have any influence on the amount of data that Facebook collects through this plugin and informs you according to its best knowledge. Through embedding the plugins Facebook receives the information that you have opened the respective website. If you are logged in to Facebook, Facebook can link this information to your Facebook account. If you interact with the plugins, for example by clicking the Like-button or commenting, your browser will submit this information directly to Facebook, which will save it. If you are not a member of Facebook, Facebook nonetheless might identify and save your IP address. Purpose and scope of the data collection as well as its distribution and usage of the data by Facebook as well as respective rights and preferences regarding privacy can be found in Facebook's privacy policy If you are a member of Facebook and do not want Facebook to collect data through this website and connect it to your Facebook profile, you have to log out from Facebook prior to visiting this site.


Meningiomas arising from the falco-tentorial junction are extremely rare. As a result their clinical presentation and surgical management are not well described. Most of the meningiomas are benign, extra-axial (without infiltration of surrounding brain, only compression), slow growing tumors originating from arachnoid cells. Rare forms are malignant, characterized by fast grown. The histological pattern of our case was fibroblastic type I meningioma according to WHO classification (benign one).


Clinical case

A recent clinical case of a 71-year-old woman with a tumor originating from both - cerebral falx and tentorium with compression and dislocation of right vein of Rosenthal and vein of Galen. The patient was admitted with signs of increased intracranial pressure, moderate left hemiparesis (2/5) and left sided homonymous hemianopsia.



The patient was positioned in right 3⁄4 prone position with Mayfield head clamp. A U-shaped skin incision was performed: the dura mater was in a X-shaped fashion constructed on top of transverse and superior sagittal sinuses. A right supratentorial occipital paramedian craniotomy was performed. CUSA – a machine transmitting ultrasound vibrations, was used for tumor breakdown.


Results and Clinical Imaging

A subtotal resection of the tumor (Okudera-Kobayashi grade IVA) was achieved concerning the compression of the veins of Rosenthal and Galen. Improvement of the overall condition was achieved, without sensory or motor deficits. Transient left-sided homonymous hemianopsia was resolved completely. The complaints and neurological deficits at the time of admission resolved postoperatively. There were no unexpected complications.



Meningiomas arising from the falcotentorial junction are quite rare. We describe in details the clinical and neuroimaging features as well as surgical management of these lesions. Overall, falcotentorial meningiomas can be safely managed by supratentorial occipital paramedian approach using CUSA. In particular cases like this one subtotal resection (Okudera-Kobayashi grade IVA) is aimed having in mind patient’s age and seeking for preservation of Galenic vein system.


Coldwell WT: Left occipital craniotomy for resection of falco tentorial meningioma. Neurosurg Focus. 2017 Oct;43(VideoSuppl2):V9. 

Hong CK, Hong JB, Park H, Moon JH, Chang JH, Lee KS, Park SW: SurgicalTreatment for Falcotentorial Meningiomas. Yonsei Med J. 2016 Jul;57(4):1022-8. 

Bassiouni H, Asgari S, König HJ, Stolke D: Meningiomas of the falcotentorial junction: selection of the surgical approach according to the tumor type. Surg Neurol. 2008 Apr;69(4):339-49. 

Quinones-Hinojosa A, Chang EF, McDermott MW: Falcotentorial meningiomas: clinical, neuroimaging, and surgical features in six patients. Neurosurg Focus. 2003 Jun 15;14(6):e11. 

Okami N, Kawamata T, Hori T, Takakura K: Surgical treatment of falcotentorial meningioma. J Clin Neurosci. 2001 May;8 Suppl 1:15-8.




Anatoli Dimitrov, MD

Neurosurgery Resident
University of Sofia (Bulgaria) 
UpSurgeOn Team