The falx cerebri is a sickle-shaped fold of dura mater descending vertically in the longitudinal fissure between the two cerebral hemispheres, attaching anteriorly to the crista galli, posteriorly to the tentorium cerebelli, and superiorly to the superior sagittal sinus groove.
Separates the cerebral hemispheres, provides dural support to the cerebral cortex, transmits the superior sagittal sinus in its superior free edge, and the inferior sagittal sinus in its inferior free edge.
Subfalcine herniation (cingulate gyrus herniating under the falx) is the most common cerebral herniation pattern in supratentorial mass lesions. Falx meningiomas arise from the dural leaves. In neurosurgery, the falx is divided in interhemispheric approaches to midline tumours and vascular malformations.
Cingulate gyrus displacement under the falx cerebri from supratentorial mass effect, producing contralateral leg weakness from compression of the ipsilateral anterior cerebral artery and motor cortex.
Meningioma arising from the falx cerebri producing parasagittal mass effect and epilepsy, resected with careful preservation of the superior sagittal sinus.
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