The patient came to the clinic 03-November-2003 complaining of headache for 13 years with vomiting for 3 years and blurred vision for 1 month and convulsions for 2 years. MRI brain done 02-November-2003 showing giant falx meningioma left occipito-parietal region. 

On examination: the patient has weak grip right hand with dysesthesia right upper limb.

left sided craniotomy in the parieto-occipital area with reflection of the flap to the left. The dura was opened parallel to the SSS and the veins were dissected and preserved. Interhemispheric approach from the left and the brain was gently retracted from the meningioma. Piece-meal resection of the tumor was coagulation of the tumor mass was achieved. This procedure was repeated until all the mass was resected, Coagulation of the falx cerebri was done so as to decrease the recurrence rate. It was impossible to resect the falx cerebri bed because the tumor was giant and it is not certain which part of the falx cerebri to remove to decrease the recurrence. The brain became lax and pulsating well and the draining veins are functioning. Routine closure of the wound. Smooth postoperative course.

The patient came to the clinic 15-November-2003 with clean wound no motor, nor sensory deficit. 45 ml was evacuated from under the wound.

The patient then came 19-Noveber-2003 and another 40 cc fluid evacuated from under the scalp. The patient then came 22-November-2003 and the wound is free of collection,  MRI brain done 14-February-2002 showing no residual of the tumor. The patient then came 01-March-2002 telling that she got convulsion with visceral manifestation and Tegretol was elevated to CR 400 twice daily. The patient then came 08-May-2005 telling that she had Jacksonian epi-attacks of the right lower limb for 2 min duration and MRI of the brain done 09-January-2005 confirming no recurrence of the tumor. MRI of the brain done 25-February-2006 ruling out recurrence of the tumor. Cardio consultation was uneventful.

The patient then came 06-June-2012 with MRI done the same day, showing small recurrence at left posterior third of the falx cerebri with PLD L5-S1 more to the left. She was advised to remove the recurrence, but she disappeared and I understood that she underwent later Gama-knife and resection of the tumor in Turkey.

There is still an estimated postoperative recurrence since the flax cerebri matrix was not removed, even practical radical resection of the meningioma was achieved.