Case ReportAgenesis of Anterior Falx Cerebri in Patient with Planned Interhemispheric Approach to Third Ventricle Mass
Introduction
Complete or partial agenesis of the falx cerebri rarely occurs in pediatric patients with developmental anomalies. However, isolated agenesis of the falx cerebri in a developmentally normal adult without concomitant agenesis of the superior sagittal sinus or corpus callosum is exceptionally uncommon. We report an adult patient with agenesis of the anterior part of the falx cerebri with obstructive hydrocephalus from a third ventricular epidermoid cyst and discuss the neurosurgical implications.
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Case Report
A 60-year-old developmentally normal female with a 3-year history of a conservatively managed third ventricular mass (Figure 1) presented with headache, altered mental status, and aphasia. Brain computed tomography and magnetic resonance imaging demonstrated interval enlargement of the mass, which originated at and extended superiorly from the inferior recesses of the third ventricle and partially through the left foramen of Monro (Figure 2). The lateral ventricles were dilated, and there was
Discussion
The falx cerebri represents the interhemispheric dural reflection separating the left and right cerebral hemispheres. Agenesis of the falx cerebri is extremely rare and most commonly associated with the alobar and semilobar forms of the holoprosencephaly spectrum as a secondary consequence of hemispheric fusion and other associated midline abnormalities.1, 2 Absence, fenestration, or hypoplasia of the dural reflections are also uncommon but well-documented sequelae of the Chiari II malformation3
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Conflict of interest statement: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.