Gravity-aided trans-falcine removal of a contralateral subcortical ependymoma

Acta Neurochir (Wien). 2007 Nov;149(11):1147-50; discussion 1150. doi: 10.1007/s00701-007-1116-2. Epub 2007 Aug 23.


The transfalcine approach is a variant of the interhemispheric approach which provides exposure of the medial surface of the contralateral hemisphere through a falx incision. Gravity can be used as a natural retractor. We report a 32-year-old woman with an ependymoma of the medial surface of the left Rolandic area that was completely removed through a contralateral gravity-aided, image-guided transfalcine approach. The contralateral transfalcine approach can be a good option for lesions presenting at the interhemispheric fissure especially those associated with perilesional oedema and avoids the risks of a transparenchymal dissection and retraction of a swollen hemisphere.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / surgery*
  • Craniotomy / methods*
  • Dominance, Cerebral / physiology
  • Ependymoma / diagnosis
  • Ependymoma / surgery*
  • Female
  • Follow-Up Studies
  • Gravitation
  • Humans
  • Image Processing, Computer-Assisted
  • Imaging, Three-Dimensional
  • Magnetic Resonance Imaging
  • Microsurgery / methods*
  • Neuronavigation / methods*
  • Temporal Lobe / pathology
  • Temporal Lobe / surgery*