Middle third falcine meningiomas-surgical nuances for cortical venous preservation.

Purpose: To improve postoperative outcome in middle third falcine meningiomas by cortical venous preservation.

Background: Falcine meningiomas arise from the falx and do not involve the superior sagittal sinus (SSS). Their complete resection is often associated with the risk of venous infarction in the eloquent cortex due to overlying superficial cortical veins on the tumors.

Method: We report one case of middle third falcine meningioma, where we used the posterior interhemispheric corridor for tumor approach.

Conclusion: Use of the posterior interhemispheric approach, carefully raised bone flap, along with sharp dissection and vein reinforcement using fibrin glue can help to preserve the cortical veins while resecting the falcine meningiomas.