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Peer-reviewedCC BY-NC-SASurgical neurology international

Dual parasagittal craniotomy for single-stage resection of non-contiguous falcine meningiomas: A case report.

  • Mehdi Mdarhri1
  • Marouan El Ouahabi1
  • Oualid Mohammed Hmamouche1
  • Marouane Hammoud1
  • Faycal Lakhdar1
  • Mohammed Benzagmout1
  • Khalid Chakour1
  • Mohammed El Faiz Chaoui1
  1. 1Department of Neurosurgery, Hassan II University Hospital, CHU Hassan II, Fez, Morocco.
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Abstract

Background

The management of multiple falcine meningiomas located in non-contiguous regions remains challenging, with no established consensus regarding the optimal surgical strategy. Single-stage resection may be limited by surgical access, whereas staged procedures increase overall treatment burden.Case description

We report the case of a 44-year-old man with no significant medical history presenting with progressive right-sided weakness and a generalized seizure. Imaging revealed two spatially distinct falcine lesions located at the anterior and posterior aspects of the middle third of the falx. A single-stage resection was performed using a dual parasagittal craniotomy ("dual window approach"), allowing direct and independent access to each lesion while preserving the superior sagittal sinus. Gross total resection was achieved, corresponding to Simpson grade II for the anterior lesion due to sinus involvement and Simpson grade I for the posterior lesion. The postoperative course was uneventful, with improvement of the neurological deficit.Conclusion

The dual-window parasagittal approach represents a practical option for selected cases of non-contiguous falcine meningiomas, enabling safe single-stage resection while minimizing venous risk and avoiding extensive exposure. Further studies are needed to define its role in comparison with conventional strategies.

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Cite

BibTeXRIS
BibTeX
@article{mdarhri2026dual,
  title = {{Dual parasagittal craniotomy for single-stage resection of non-contiguous falcine meningiomas: A case report.}},
  author = {Mehdi Mdarhri and Marouan El Ouahabi and Oualid Mohammed Hmamouche and Marouane Hammoud and Faycal Lakhdar and Mohammed Benzagmout and Khalid Chakour and Mohammed El Faiz Chaoui},
  journal = {Surgical neurology international},
  year = {2026},
  month = oct,
  doi = {10.25259/sni_581_2026},
  url = {https://europepmc.org/article/MED/42974521},
  note = {CC BY-NC-SA},
}
RIS
TY  - JOUR
TI  - Dual parasagittal craniotomy for single-stage resection of non-contiguous falcine meningiomas: A case report.
AU  - Mehdi Mdarhri
AU  - Marouan El Ouahabi
AU  - Oualid Mohammed Hmamouche
AU  - Marouane Hammoud
AU  - Faycal Lakhdar
AU  - Mohammed Benzagmout
AU  - Khalid Chakour
AU  - Mohammed El Faiz Chaoui
PY  - 2026
DA  - 2026/10/09
JO  - Surgical neurology international
DO  - 10.25259/sni_581_2026
UR  - https://europepmc.org/article/MED/42974521
AB  - Background  The management of multiple falcine meningiomas located in non-contiguous regions remains challenging, with no established consensus regarding the optimal surgical strategy. Single-stage resection may be limited by surgical access, whereas staged procedures increase overall treatment burden.Case description  We report the case of a 44-year-old man with no significant medical history presenting with progressive right-sided weakness and a generalized seizure. Imaging revealed two spatially distinct falcine lesions located at the anterior and posterior aspects of the middle third of the falx. A single-stage resection was performed using a dual parasagittal craniotomy ("dual window approach"), allowing direct and independent access to each lesion while preserving the superior sagittal sinus. Gross total resection was achieved, corresponding to Simpson grade II for the anterior lesion due to sinus involvement and Simpson grade I for the posterior lesion. The postoperative course was uneventful, with improvement of the neurological deficit.Conclusion  The dual-window parasagittal approach represents a practical option for selected cases of non-contiguous falcine meningiomas, enabling safe single-stage resection while minimizing venous risk and avoiding extensive exposure. Further studies are needed to define its role in comparison with conventional strategies.
SN  - 2229-5097
SN  - 2152-7806
ER  -