The patient came to the clinic 03-November-2003 complaining of headache for 13 years with blurring vision for 1 month. Vomiting attacks for 3 years. Convulsions for 2 years. MRI brain done 02-November-2003 showing huge falx meningioma left occipito-parietal region.

On examination: the patient is stable in Romberg stance and having mild paresis of the right upper and lower limbs with dysesthesia left lower limb.

Osteoplastic craniotomy over the left occipito-parietal region with the SSS exposed in the field. The flap reflected to the left ear. The dura was opened and the falx cerebri was followed down to expose the tumor, which was identified and piece-meal resection was proceeded. The fresh frozen section was of typical meningioma. There was many feeders which were coagulated and dissection of the plane between the tumor and the brain was was respected.  Practical total resection of the tumor was achieved. The matrix in the falx cerebri was coagulated. Strict hemostasis and routine closure of the wound.  Smooth postoperative recovery and the patient was sent to the ICU for 24 hours observation.

The patient came to the clinic 15-November-2003 with clean wound but with subgalial collection and 45 ml collection was removed. Neurologically she improved.

The patient then came 19-November-2003 and 40 cc subgalial collection removed.

The patient then came several times and 10-February-2004 the wound was clean without collection and she was advised to keep in Tegretol for convulsion control. MRI done 14-February-2004 showing no residual of the tumor. MRI brain repeated 09-January-2005 showing no evidence of recurrence of the meningioma. She was without recurrence until she performed MRI of the brain 06-June-2012 showing small recurrence at the left posterior aspect of the falx cerebri.. She was advised for surgery, but due to political circumstances she perform Gamma-knife followed with surgery in Turkey. She tried to have after then help by telephone and I told her to be followed by her Turkish doctors.

The real radical resection must include removal of the tumorous flax cerebri part, which was not performed in this surgery.