Posterior interhemispheric approach for a large falcotentorial meningioma

The posterior interhemispheric approach can be useful in accessing a wide range of lesions in the falcotentorial region. We demonstrate the case of a 59-year-old woman with a long history of headache who was found to have a large falcotentorial meningioma on imaging workup. The deep venous structures of the Galenic complex were displaced inferiorly by the tumor, thus indicating a supratentorial approach. Risks and alternatives to the approach demonstrated in this video were discussed with the patient, and she wished to proceed. The patient was positioned in a three-quarters prone (“park bench”) position in order to allow gravity retraction of the right hemisphere, which facilitated tumor visualization. The tumor was removed completely, and the patient tolerated the procedure well without complication. Patient consent was obtained for the use of the operative video. Used with permission from Barrow Neurological Institute, Phoenix, Arizona. © 2020 The Authors