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Meningiomas are common intracranial tumors in adults but rare in pediatric cases, with malignant histological features being even less frequent. Primary pediatric malignant meningioma of the falx cerebri has not been previously reported in the literature. We present a case of a malignant meningioma of the falx cerebri in a child who was admitted to the hospital following head trauma, presenting with mental impairment and limb weakness. CT examination revealed a right parietal epidural hematoma and a large intracranial lesion. The patient underwent drainage of the intracranial hematoma and a two-frontal craniotomy with tumor resection under microscopy. Histopathological analysis confirmed malignant meningioma, and genetic testing identified a YAP1-MAML2 gene fusion. There is no consensus on the clinical, imaging, and pathological features of pediatric meningiomas. In this paper, we discuss the clinical features, diagnostic and treatment protocols, and pathological characteristics of this case, along with a review of the relevant literature. [ABSTRACT FROM AUTHOR]

Dural arteriovenous fistulas (DAVFs) within the falx cerebri are infrequently documented and may be linked with the falcine sinus/venous plexus. The falcine sinus/venous plexus, often regarded as a normal venous structure, can exhibit pathological characteristics, differing from the persistent fetal falcine sinus. A retrospective analysis was conducted at a single center to identify all cases of DAVFs within the falx cerebri spanning from 2002 to 2022. Demographic data, fistula features, treatment modalities, clinical outcomes, and fistula closure were collected and analyzed. Additionally, relevant literature on DAVFs in this location was reviewed. Ten cases were identified at our center, supplemented by 13 cases reported in the literature. In our cohort, patients had an average age of 49.4 ± 8.1 years, with a male predominance of 90%. Trans-arterial embolization (TAE) alone achieved immediate complete occlusion in eight cases, while conservative treatment was pursued in two cases. No treatment-related complications or fistula recurrences were observed. In the literature, seven patients underwent direct surgery, three underwent TAE, and one underwent both direct surgery and radiosurgery for complete fistula closure. No instances of fistula recurrence or treatment complications were reported. Dural arteriovenous fistulas within the falx cerebri are rare, with limited literature available. They typically present as aggressive lesions. Treatment options include direct surgery or TAE. However, due to a lack of long-term DSA follow-up, the cure and recurrence rates are unknown for endovasdcular therapy. Further investigation is warranted to elucidate the involvement of the falcine sinus/venous plexus in falx cerebri DAVFs. [ABSTRACT FROM AUTHOR]

Background: Simultaneous sampling of the cingulate gyri through a single depth electrode inserted underneath the falx cerebri is clinically useful in certain cases of drug-resistant epilepsy. However, the frequency at which each region of the cingulate gyri - namely, anterior, middle, and posterior - can be simultaneously sampled with a single electrode remains uncertain. Methods: We assessed the anatomical relationship between the falx cerebri and the cingulate gyrus in 50 adults and children. Subsequently, we determined whether an arbitrary line, denoted as A (representing a 5 mm gap between the falx cerebri and corpus callosum necessary for depth electrode insertion), fell within the anterior, middle, or posterior cingulate gyrus. Results: The shape of the falx cerebri and its intersection point with the corpus callosum varied substantially across individuals, with a significant difference between children and adults (P = 0.02). The A line was located in the middle cingulate gyrus in 18 children (72%), while 3 (12%) and 4 (16%) had it located in the posterior and anterior cingulate gyrus, respectively. Among adults, 15 individuals (60%) had the A line in the middle cingulate gyrus, 10 (40%) in the posterior cingulate gyrus, and none in the anterior cingulate gyrus. Conclusion: This study demonstrates the feasibility of simultaneous sampling of both the anterior and middle cingulate gyri in adults and children. Moreover, it represents the first investigation to document the wide interindividual variability in the morphology of the falx cerebri and its association with the cingulate gyrus. [ABSTRACT FROM AUTHOR]

Background: Composite hemangioendothelioma (CHE) is a rare, locally aggressive neoplasm of intermediate malignant potential. It is composed of a mixture of vascular tumors with a predilection for the dermis and subcutis of the extremities. Case Description: In this report, we describe a 41-year-old man who presented with a 2-month history of headache, dizziness, and intermittent seizures. Magnetic resonance imaging showed a hemorrhagic, multilobulated, and dural-based mass with extension into the calvarium. The mass measured 10.3 × 4.8 × 4 cm along the interhemispheric fissure and encased the superior sagittal sinus. Excision was performed, and histopathologic examination revealed a heterogeneous mixture of vascular components consisting of epithelioid hemangioendothelioma, retiform hemangioendothelioma, and hemangioma. This is the first report of a primary intracranial CHE. Conclusion: The spectrum of mesenchymal neoplasms within the cranium expands to encompass CHE. [ABSTRACT FROM AUTHOR]

Cranial dural arteriovenous (AV) fistulas are abnormal connections between the branches of dural arteries to dural veins or venous sinuses. They are most frequently located at the transverse sinus and cavernous sinus. They can occur at every cranial dural sinus. Dural AV fistula of falx cerebri is rare. A 62-year-old female presented with signs and symptoms of raised intracranial pressure. Radiological imaging revealed a dural AV fistula at the posterior one-third falx cerebri. She underwent transarterial embolization, and complete obliteration of the fistula was achieved. A detailed digital subtraction angiography study is warranted in patients with seemingly benign complaints like recurrent headaches, and falcine dural AV fistula should be identified and treated in the nick of time. We describe a very rare falcine dural AV fistula case and its management. [ABSTRACT FROM AUTHOR]

A method of automatic detection of human brain symmetry plain in computed tomography (CT) images is described. An algorithm consists of four steps: region of interest, symmetry curve detection, symmetry axis evaluation and calculation of symmetry plane. Symmetry plane are calculated using vertex slices of human brain CT images. There are approximately 40 which has symmetry curve `` ` Falx cerebri'' property. In the first, using this feature symmetry axis in slice detected. In second, coordinates of detected symmetry axis and least square method are used to calculate symmetry plane. In others images where symmetry property is not available symmetry axis is projection of calculated plane.

We present a rare case of ossification of the falx cerebri in a 25-year-old man, discovered incidentally on a craniofacial computed tomodensitometry (CT) scanner. This ossification presented a true cortico-medullary differentiation and pushed aside the right frontal lobe. There was no associated clinical manifestation. [ABSTRACT FROM AUTHOR]

The pan-sirenian Bauplan is conservative, probably owing to the constraints of adaptation to an aquatic lifestyle. Gathering morphological data from extinct forms is complex, resulting in poorly resolved phylogenies for stem pan-sirenians. Extant sirenians ossify the falx cerebri and the tentorium cerebelli, membranes of the dura mater of the brain attached to the parietal bone. Nevertheless, these ossifications are not present in some pan-sirenians. The basioccipital bone has received little attention in the literature except for establishing the relative age of individuals. Here, we present new cranial elements and a detailed description of the skull of Sobrarbesiren cardieli , a stem pan-sirenian from the Lutetian of Spain represented by eight individuals; we study its intraspecific variation and palaeoecological implications and explore the evolution of the endocranial structures and the basioccipital bone in pan-sirenians. Six new phylogenetic characters are added to the latest pan-sirenian dataset, resulting in a well-resolved topology where Sobrarbesiren is recovered close to the root, in a clade with Prototherium and Eotheroides aegyptiacum. The basioccipital bone and the ossified endocranial membranes have a phylogenetic signal, and the absence of such endocranial structures represents the plesiomorphic condition for pan-sirenians and is not diagnostic for the family Protosirenidae as previously believed. [ABSTRACT FROM AUTHOR]

To perform measurements in normal brain imaging studies from the free edge of the falx cerebri to the genu and the body of the corpus callosum and perform a statistical analysis based on age, type of study, and sex highlighting potential surgical implication of these measurements. In 193 normal brain imaging studies, 3 anatomical points of the corpus callosum were used to measure the distance to the falx cerebri. Horos and RadiAnt DICOM Viewer software were used to perform the measurements. Statistical analysis of data was performed with Minitab18 software. The results obtained in computed tomography (CT) studies were: distance A, mean 2.1065 cm; distance B, mean 2.2677 cm; distance C, mean 1.765 cm. The results obtained in magnetic resonance imaging studies were: distance A, mean 1.7148 cm; distance B, mean 2.1197 cm; distance C, mean 1.5321 cm. Statistically significant differences were obtained in measurements related to the type of study and in measurements made in CT studies related to age. There is a distance from the free edge of the falx cerebri to the genu and body of the corpus callosum of at least 1 cm in both CT and magnetic resonance imaging studies of normal brains. Statistically significant differences were found in the measurements in relation to the type of study and in relation to age in the measurements made in CT studies. These measurements could be important in determining the extent of bone resection in certain types of decompressive craniectomies. [ABSTRACT FROM AUTHOR]

Hydranencephaly (HE) is a rare congenital anomaly in which there is a complete or near complete absence of bilateral cerebral hemispheres which are replaced by a membranous sac filled with Cerebrospinal Fluid (CSF). Thalami, brainstem, and cerebellar hemisphere are preserved. A small island of cerebral parenchyma may also be seen along the inner aspect of the calvarium. Several theories regarding its aetiopathogenesis have been postulated with the hypothesis of bilateral occlusion of supraclinoid segment of Internal Carotid Artery (ICA) being widely accepted. The authors present a case of a two-month-old male child presenting with increasing head size since birth, associated hydrocephalus and residual parenchymal sleeve visualised on neurosonogram and calcifications depicted on computed tomography. The diagnosis of Cytomegalovirus (CMV) was confirmed serologically and further neurosurgical consultation was advised for increasing head size secondary to hydrocephalus. The HE is usually detected in the second trimester, however can also occur in early or later gestation and has a very poor prognosis.

Extensive ossification of the falx cerebri occur rarely however are described in the world literature references. Ossifications may concern both cerebral falx and other dural structures: tentorium. They are most often incidental findings and occurrence frequency in the population is remains unclear. The authors of the study are reviewing references on this subject, based on a case of extensive falx ossification. Manuscript describes the case of incidental detected of extensive calcification of the anterior brain sickle in a patient after head injury. Computed tomography revealed no pathology, but extensive ossification of falx was described. The patient did not complain of any significant complaints or neurological symptoms. The described calcification constituted a median and sagittal bone or calcium plate separating the frontal lobes of the brain. Analyzing references did not identify such extensive ossification of falx cerebri in human, however dural ossifications are reported in the references.

Pituitary carcinoma is a condition defined by metastasis of a pituitary tumor to a distant location, and it is a very rare type of adenohypophyseal tumor. We present a case of a 29-year-old female who was followed up in our Endocrinology Department. Past medical history included the diagnosis of Cushing disease and transsphenoidal tumor resection at 12 years of age, followed by transcranial resection two years later because of persistently elevated adrenocorticotropic hormone (ACTH). Despite the surgical management, the patient persisted with increased ACTH and hypercortisolism, and, thus, bilateral adrenalectomy was performed a year later. Two years after the procedure, the patient presented with a newly diagnosed pituitary macroadenoma, and the diagnosis of Nelson syndrome was made. Linear accelerator radiotherapy was given, which reduced the size of the tumor. Later, several imaging studies showed multiple lesions on the falx cerebri, posterior clinoid process, retroclival region, cerebellopontine angle, pterygopalatine fossa, infratentorial region, and posterior ethmoidal cells. Biopsy and immunohistochemistry of the falx cerebri lesions described ACTH-producing pituitary adenocarcinoma. Treatment was given with intramuscular octreotide, dabrafenib, and trametinib. Despite persistently elevated ACTH levels, the patient has since remained clinically stable, without new development or worsening of symptoms. There are three unique aspects of our case. First, we reported an unusual presentation of this disease, since the patient in our case was a female with an early age of onset. Second, this is the first reported case demonstrating pituitary carcinoma in the falx cerebri. Third, the prognosis of pituitary carcinoma is usually very poor, and mortality is extremely high; however, the patient in our case has been followed up for seven years since the diagnosis of the metastatic lesions and has remained clinically stable., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Esquivel et al.)

Purpose: To date, no study has explored the inferior sagittal sinus (ISS) using neuroimaging modalities. This investigation aimed to characterize it using magnetic resonance imaging (MRI). Methods: A total of 77 patients with intact cerebral hemispheres and covering meninges underwent thin-sliced, contrast-enhanced MRI. Results: The ISS was well delineated as a linear structure with a constant diameter in 97% of the patients. The maximum intensity projection (MIP) images well delineated the three-dimensional architecture of the ISS and relevant veins. The identified ISSs could be classified into three different types, with the underdeveloped type being the most frequent at 47%. In addition, the ISSs showed considerable variability both in the original site and course along the lower margin of the falx cerebri. Furthermore, in 22% of the cases, fenestrations were identified in the falx cerebri adjacent to or near the ISS. More than 70% of them were located in the middle third of the falx, followed by the anterior and middle thirds of the falx. Conclusions: The ISS is a constant venous structure characterized by morphological variability and may function as an adjunctive or assistive venous drainage route. Thin-sliced, post-contrast-enhanced sagittal MRI combined with MIP imaging is useful for exploring the ISS. [ABSTRACT FROM AUTHOR]

The meninges are membranous tissues that are pivotal in maintaining homeostasis of the central nervous system. Despite the importance of the cranial meninges in nervous system physiology and in head injury mechanics, our knowledge of the tissues' mechanical behavior and structural composition is limited. This systematic review analyzes the existing literature on the mechanical properties of the meningeal tissues. Publications were identified from a search of Scopus, Academic Search Complete, and Web of Science and screened for eligibility according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The review details the wide range of testing techniques employed to date and the significant variability in the observed experimental findings. Our findings identify many gaps in the current literature that can serve as a guide for future work for meningeal mechanics investigators. The review identifies no peer-reviewed mechanical data on the falx and tentorium tissues, both of which have been identified as key structures in influencing brain injury mechanics. A dearth of mechanical data for the pia-arachnoid complex also was identified (no experimental mechanics studies on the human pia-arachnoid complex were identified), which is desirable for biofidelic modeling of human head injuries. Finally, this review provides recommendations on how experiments can be conducted to allow for standardization of test methodologies, enabling simplified comparisons and conclusions on meningeal mechanics. [ABSTRACT FROM AUTHOR]

Background: Intracranial chondrosarcomas are slowly growing malignant cartilaginous tumors that are especially rare in adolescents. Case Description: A 19-year-old woman with no medical history presented with symptoms of intermittent facial twitching and progressive generalized weakness for 6 months. The patient's physical examination was unremarkable. Imaging revealed a large bifrontal mass arising from the falx cerebri, with significant compression of both cerebral hemispheres and downward displacement of the corpus callosum. The patient underwent a bifrontal craniotomy for gross total resection of tumor. Neuropathologic examination revealed a bland cartilaginous lesion most consistent with low-grade chondrosarcoma. Her postoperative course was uneventful, and she was discharged to home on postoperative day 3. Conclusion: This is an unusual case of an extra-axial, non-skull base, low-grade chondrosarcoma presenting as facial spasm in an adolescent patient. [ABSTRACT FROM AUTHOR]

Object To investigate the clinical characteristics and treatment of cerebral falx dural arteriovenous fistula( DA VF) . Methods The clinical data of a case of complex cerebral falx DA VF with multiple ectasia and hemorrhage treated by combined surgery were analyzed retrospectively, and the related literature was reviewed. Results The patient presented with subarachnoid hemorrhage. After endovascular embolization, angiography showed that the fistula still existed and the artery still supplied blood. Craniotomy was performed to remove the fistula. The patient recovered well without neurological deficit, and no recurrence of DA VF was found on DSA one year after operation. Conclusion Endovascular embolization combined with craniotomy combined with surgical treatment of complex cerebral falx DA VF is effective and safe. [ABSTRACT FROM AUTHOR]

Objectives. Although the agenesis of corpus callosum is currently a second-trimester diagnosis, it is a worthwhile pursuit to lower the gestational age at which this pathology should be at least suggested, if not diagnosed. Materials and method. We performed an ultrasound examination (2D and 3D) on women with a sigleton or twin pregnancy at 12 to 14 weeks of gestation. Images with measurements of midbrain and falx cerebri were acquired and their ratio computed, along with 3D volume with power Doppler images of the pericallosal arteries. We also performed a follow- up scan at 20-22 weeks of gestation in order to confirm the absence of the corpus callosum. Results. Nineteen fetuses with high suspicion on the first trimester were found with agenesis of corpus callosum at the second-trimester scan. Conclusions. Ultrasound measurements of midbrain/falx cerebri with calculated ratio and pericallosal artery in the first trimester could be a matter of concern for agenesis of corpus callosum. [ABSTRACT FROM AUTHOR]

The unilateral anterior interhemispheric approach has been widely used for distal anterior cerebral artery (DACA) aneurysms. However, there are some drawbacks of this approach because of the narrow operative field, including possible brain traction injury, bridging vein injury, and inadequate exposure of the aneurysm. Here, we report a case of a DACA aneurysm covered by the falx that could not be totally exposed with the unilateral interhemispheric approach. We successfully obtained a wide view with wedge resection of the falx, avoiding excessive brain traction and division of the superior sagittal sinus. A 76-year-old woman with a 6-mm unruptured DACA aneurysm underwent a unilateral craniotomy with the anterior interhemispheric approach. In the operative field, the aneurysm was found at the midline, just below the falx. The aneurysm was covered by the falx and could not be completely exposed with the usual brain retraction. Therefore, we performed wedge resection of the falx, thus obtaining sufficient surgical field and totally exposing the aneurysm. We were then able to apply the clip successfully. Postoperative brain computed tomography angiography showed no remnant aneurysm sac or complications of falx resection or brain retraction, such as bleeding or vessel injury. When an aneurysm is located just below the falx and is exposed inadequately, performing wedge resection of the falx can expose the aneurysms adequately for application of the clip. [ABSTRACT FROM AUTHOR]

Background: We aimed to assess the usefulness of the falx cerebri and the corpus callosum measurements as imaging markers of the evaluation of patients with bilateral subdural hematomas., Methods: The anterior-posterior and craniocaudal distances between the falx cerebri (FC) and the corpus callosum (CC) were retrospectively measured in 88 head CT scans from 2018 to 2022 from patients with bilateral subdural hematomas and associated with quantitative data and clinical outcomes. Statistical analysis was performed using multivariate regression and receiver operating characteristic curves., Results: Of the 88 patients included, 77.3% were male and the median age of 76.0 years (interquartile range 14.0). The mean craniocaudal and anterior-posterior FC-CC distances were 27.6 ± 6.2 mm and 25.1 ± 6.9 mm, respectively, and showed a positive correlation with hematoma thickness and volume. Both anterior-posterior and craniocaudal FC-CC distances exhibited moderate to good inter-rater reliability. After adjusting for confounders, the craniocaudal FC-CC distance was associated with an increased risk of altered consciousness at admission (OR=1.013; 95% CI 1.001-1.024; p = 0.031), downward displacement of the third ventricle (OR=1.019; 95% CI 1.001-1.038; p = 0.035), and a reduced time to surgery (β = 0.057; 95% CI 0.007-0.107; p = 0.027)., Conclusion: This study emphasizes that increased FC-CC distances in patients with bilateral subdural hematomas may aid clinical decision-making and are associated with larger hematoma volumes, evidence of descending transtentorial herniation on imaging, and a heightened risk of altered consciousness at admission., Competing Interests: Declaration of Competing Interest The authors have no competing interests to declare that are relevant to the content of this article., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background Schwannomas not related to cranial nerves are rare. Here, we present a case of a schwannoma that originated from the falx cerebri and review reported cases in the literature. Case Description A 36-year-old male experienced generalized seizures following right hemiparesis predominantly in his lower extremity. Magnetic resonance imaging revealed a round tumor attached to the falx cerebri on the left side. Radiologically, the tumor appeared to be a falx meningioma. We performed gross total removal of the tumor. Pathology showed a schwannoma that originated from the falx cerebri. Right hemiparesis disappeared soon after surgery. Conclusion Although distinguishing a schwannoma of the falx cerebri from a falx meningioma and metastasis is difficult preoperatively, inclusion of schwannoma of the falx cerebri in the differential diagnosis is important, especially when the patient is relatively young and/or the tumor lacks a dural tail sign. [ABSTRACT FROM AUTHOR]

Purpose: The falx cerebri, falx cerebelli, and tentorial notch exhibit a peculiar morphology with a two-layered, dural leaf that protrudes into the cranial cavity with a free edge. However, there are few studies exploring this morphology using neuroimaging techniques. The present study aimed to explore these dural structures using magnetic resonance imaging.Methods: A total of 65 outpatients were included in this study. Following initial examinations with conventional sequences, the constructive interference in steady-state (CISS) sequences were performed in thin-sliced, coronal sections.Results: In 78% of the subjects, the interdural spaces presenting with high signal were identified in the falx cerebri. These spaces were located adjacent to the uppermost part of the falx, formed by two dural leaves and the superior sagittal sinus, and tapered downward where the leaves united to form the falx cerebri. At the tentorial notch, these spaces were found in 52% of the 65, most predominantly in the medial edge followed by the tentorium cerebelli-tentorial notch junctional region. Forty-one percent of patients had a dural opening into the cerebral cistern. The interdural spaces with high signal were not identified in the tentorium cerebelli in any of the subjects.Conclusions: The falx cerebri and tentorial notch form the interdural spaces that may provide alternative cerebrospinal fluid pathways. The coronal CISS sequence is suitable for delineating such interdural spaces. [ABSTRACT FROM AUTHOR]

Purpose: Few studies have characterized the venous channels of the falx cerebri under physiological conditions. The present study aimed to explore the falx cerebri using magnetic resonance imaging (MRI).Methods: A total of 91 patients (41 men and 50 women) with an intact falx cerebri and relevant dural sinuses underwent contrast MRI.Results: In 15% of the participants, the falx cerebri contained venous channels with a patchy appearance. Seven of these channels were located in the anterior third of the falx, two were in the anterior two-thirds, and 5 were in the middle third. In 19 (21%) participants, the falcine sinus was unequivocally delineated. In 14 of them, connected the posterior third of the superior sagittal sinus and uppermost part of the straight sinus. These sinuses showed variable morphologies, presenting with linear, triangular, multi-channel, and branching appearances. The linear type was the most predominant and found in 50% of these cases. In contrast, in the remaining five participants, the falcine sinuses were coursing posteriorly, connecting the posterior third of the falx cerebri with the superior sagittal sinus.Conclusion: The falx cerebri may have a role as a pathway in the intracranial venous circulation. The falcine sinus has several variants with diverse morphologies. [ABSTRACT FROM AUTHOR]

Background Various techniques have been used for wrap-clipping a ruptured, fusiform intracranial aneurysm; however, there is no available literature on use of the falx cerebri for wrap-clipping. We present a review of the literature, with an illustrative case, of a ruptured fusiform pericallosal artery aneurysm firmly attached to the lower edge of the falx cerebri and not amenable to endovascular intervention. Methods Although the firm attachment between the inferior falx and the fusiform aneurysm was maintained, a section of the lower thinner part of the falx cerebri firmly attached to the aneurysm was dissected and wrapped around the fusiform aneurysm, and then stabilized with a fenestrated clip. We chose a segment slightly longer than the length of the fusiform aneurysm to avoid pre– and post–wrap-clipping stenosis. Results Postprocedure, except for a small area of numbness on the left distal anterolateral left leg, the patient was neurologically intact and remained neurologically intact at a 12-month follow-up. Conclusions An inferior thin segment of the falx cerebri can be used for wrap-clipping of ruptured fusiform anterior cerebral artery aneurysms. Furthermore, the inferior falx can be wrapped around the attached fusiform anterior cerebral artery aneurysm without compromising flow, offering a safe solution in these unusually complex cases. [ABSTRACT FROM AUTHOR]

Introducion. Intracranial chondroma is a very rare, slow growing, benign cartilaginous tumor that arises usually from the base of the scull. Chondroma located at the falx is extremely rare. According to our best knowledge 15 cases of falx chondromas have been reported in the literature. Case Outline. This is the first case report of falx chondroma located in the parietal area associated with hyperostosis. Magnetic resonance imaging of the brain revealed a 3Ч4Ч4 cm solid, calcified, ring-shaped, well-defined tumor at the posterior falx. The patient underwent surgery and complete resection was performed. Histological examination confirmed chondroma of the falx. Postoperative CT scan showed no residual of tumor and the patient was discharged. Conclusion. The long-term prognosis is good after a total excision of the tumor. Awareness of this rare pathology in the differential diagnosis of falx mass could facilitate the diagnosis.

Purpose: The foramen cecum (FC) is a fine bony canal with the aperture located immediately anterior to the crista galli (CG). The venous structures in the regions of the FC and CG have been inconsistently described and are not well understood. Here we explore these veins using magnetic resonance imaging. Materials and methods: We enrolled 101 patients who underwent contrast examinations and exhibited intact skin, skull, dura mater, and intracranial dural sinuses. Imaging data were obtained as thin-sliced, seamless sagittal sections and were transferred to a workstation for analysis. Results: In 84 % of the patients, tubular-shaped venous extensions arose from the rostral end of the falx cerebri and were confirmed to lie in the FC. These extensions were supplied by the superior sagittal sinus or the frontal cortical vein, and were classified into four types: rudimental slight projections, short and straight extensions, long and straight channels, and long and tortuous channels. Furthermore, 27.7 % of the patients exhibited a distinct venous channel between the venous extension in the FC and the median vestibular submucosa of the nasal cavity. Among these channels, 81.5 % were connected to the vein lying in the FC via a short channel that vertically pierced the CG. Conclusions: The FC contains tubular-shaped venous extensions that are supplied by the rostral end of the superior sagittal sinus or the frontal cortical vein. The cranial cavity, FC, and nasal cavity may be connected by a venous channel. [ABSTRACT FROM AUTHOR]

Background: A dural arteriovenous fistula in the falx cerebri is a relatively rare lesion, with only two cases reported till date. One was treated with direct surgery, and the other was followedup conservatively. Advances in catheter design and embolic materials have made safe and curative transarterial embolization of dural arteriovenous fistulas possible in the current era. Case Description: We describe a 67yearold man with left putaminal hemorrhage who was diagnosed with an arteriovenous fistula in the anterior part of the falx cerebri that was treated with curative transarterial glue embolization through the middle meningeal artery by using nbutyl cyanoacrylate. Conclusion: Although the procedure was safely performed, understanding the potential risks of the migration of embolic materials into the ophthalmic and anterior cerebral artery system is mandatory. [ABSTRACT FROM AUTHOR]

Here, we report the case of an incidental finding of lamellar calcification of the falx cerebri in a routine computed tomography scan of the head after an accidental trauma. This lamellar calcification led to the diagnosis of Gorlin-Goltz syndrome (GGS) in the patient and her daughter. Lamellar calcification of the falx cerebri is a pathognomonic feature of GGS. Our case report highlights the importance of a multidisciplinary diagnostic approach to GGS.

Gorlin syndrome (GS) is a rare hereditary multisystem disorder caused by mutations in PTCH1, PTCH2, or SUFU. It is characterized by multiple anomalies and an increased risk of developing various tumors. Basal cell carcinoma is most common, and medulloblastoma (MB) is especially frequent in patients with SUFU mutations. MB treatment often includes radiation therapy in patients older than 3 years; however, such treatment is very toxic to patients with GS. Most reported cases of MB in patients with GS present after GS is diagnosed. We report a male toddler with multicentric posterior fossa tumor and calcifications along the falx cerebri, suggesting MB and GS. Pathology revealed nodular MB. His testing confirmed a germline SUFU mutation. His tumor resolved with three induction cycles of chemotherapy, but he died of respiratory failure due to infection at 20 months of age. Overlooking calcifications along the falx cerebri in children with MB can induce significant morbidity. [ABSTRACT FROM AUTHOR]

Background Complete or partial agenesis of the falx cerebri may occur in pediatric patients with developmental anomalies. However, isolated agenesis of the falx in a developmentally normal adult is exceptionally rare. We describe the first reported case of a patient with a third ventricular mass associated with partial agenesis of the anterior falx cerebri, a circumstance that influenced surgical access to a third ventricular epidermoid cyst. Case Description A 60-year-old developmentally normal woman presented with progressively worsening aphasia and altered mental status. Brain magnetic resonance imaging showed obstructive hydrocephalus from a third ventricular mass. An anterior interhemispheric transcallosal approach was planned to remove the tumor. However, upon dural opening there was no evidence of a falx cerebri, an anomaly visible but not reported on the prior imaging studies. An interhemispheric fissure was present, but the medial frontal lobes were densely adherent, with multiple traversing veins within the superficial arachnoid of the fissure. Therefore, a left frontal transcortical approach was performed for microsurgical resection of the tumor. Histopathologic analysis identified the lesion to be an epidermoid cyst. Conclusions Partial agenesis of the falx cerebri is exceedingly rare in a developmentally normal adult, particularly in the presence of an anatomically normal superior sagittal sinus. If present, however, it is important to note this association preoperatively because partial agenesis of the falx cerebri precludes an interhemispheric transcallosal approach to the lateral and third ventricles. [ABSTRACT FROM AUTHOR]