Background: Craniovertebral junction (CVJ) schwannomas are rare, with surgery and stereotactic radiosurgery (SRS) being effective yet challenging options. We systematically reviewed the literature on CVJ schwannomas. Methods: PubMed, Scopus, Web-of-Science, and Cochrane were searched following the PRISMA statement to include studies reporting CVJ schwannomas. Clinical features, management, and outcomes were analyzed. Results: We collected 353 patients from 101 included articles. Presenting symptoms were mostly neck pain (30.3%) and headache (26.3%), with most cranial neuropathies involving the XII (31.2%) and X (24.4%) nerves. Most tumors originated from C2 (30.9%) and XII (29.4%) nerves, being extracranial (45.1%) and intradural-extradural (44.2%). Erosion of C1–C2 vertebrae (37.1%), the hypoglossal canal (28.3%), and/or jugular foramen (20.1%) were noted. All tumors were operated, preferably with the retrosigmoid approach (36.5%), with the far-lateral approach (29.7%) or with the posterior approach and cervical laminectomy (26.9%), far-lateral approaches (14.2%), or suboccipital craniotomy with concurrent cervical laminectomy (14.2%). Complete tumor resection was obtained most frequently (61.5%). Adjuvant post-surgery stereotactic radiosurgery was delivered in 5.9% patients. Median follow-up was 27 months (range, 12–252). Symptom improvement was noted in 88.1% of cases, and cranial neuropathies showed improvement in 10.2%. Post-surgical complications occurred in 83 patients (23.5%), mostly dysphagia (7.4%), new cranial neuropathies (6.2%), and cerebrospinal fluid leak (5.9%). A total of 16 patients (4.5%) had tumor recurrence and 7 died (2%), with median overall survival of 2.7 months (range, 0.1–252). Conclusions: Microsurgical resection is safe and effective for CVJ schwannomas. Data on SRS efficacy and indications are still lacking, and its role deserves further evaluation.

Background: In the present study, we aim to develop simulation models based on computed tomography angiography images of intracranial aneurysms (IAs) and their parent vessels using three-dimensional (3D) printing technology. The study focuses on the value of these 3D models in presurgical planning and intraoperative navigation and ultimately their impact on patient outcomes. To the best of our knowledge, this is the first report of its kind from a war-torn country, like Iraq. Methods: This is a prospective study of a series of 11, consecutively enrolled, patients suffering from IAs for the period between February and September 2019. The study represents a collaboration between the two major neurosurgical centers in Baghdad/Iraq; Neurosciences Teaching Hospital and Neurosurgery Teaching Hospital. We analyzed the data of eleven patients with IAs treated by microsurgical clipping. These data include patient demographics, clinical, surgical, and outcomes along with the data of the 3D-printed replica used in these surgeries. All cases were operated on by one surgeon. Results: Our study included 11 patients, with a total of 11 aneurysms clipped. The mean age was 44 ± 8, with a median of 42.5 and a range of 35–61 years. About 60% of our patients were female with a female-to-male ratio of 1:5. About 60% of the aneurysms were located at the anterior communicating artery (Acom) while the remaining 40% were equally distributed between the posterior communicating and internal carotid arteries bifurcation. The standard pterional approach was followed in 50% of cases, whereas the other 50% of patients were treated through the lateral supraorbital approach. About 90% (n = 9) of the patients had a Glasgow Outcome Scale (GOS) of 5 and 10% had a GOS of 4. The 3D-printed models successfully replicated the aneurysm size, location, and relation to the parent vessel with 100% accuracy and were used for intraoperative guidance. The average production time was 24–48 h and the production cost was 10–20 US dollars. Conclusion: 3D printing is a promising technology that is rapidly penetrating the field of neurosurgery. In particular, the use of 3D-printed patient-matched, anatomically accurate replicas of the cerebral vascular tree is valuable adjunct to the microsurgical clipping of IAs, and our study conclusions support this concept. However, both the feasibility and clinical utility of 3D printing remain the subject of much, ongoing investigations.

Background: Neuroanatomy is the core basis for neurosurgical excellence. The quantity of accessible neuroanatomy resources has witnessed exponential growth in recent years. Accumulating a list of popular sources and getting them ranked by neurosurgeons was the motivation behind this investigation.Methods: A list of neuroanatomy resources was compiled using Google search wherein multiple sets of variable combinations of keywords were used. A three-section, eleven-item questionnaire was designed by two neurosurgeons and revised by a third independent reviewer. Neurosurgeons from different parts of the world were invited to participate. The participants were asked to rank the neuroanatomy textbook and non-book online source that they would recommend to neurosurgeons and the features that make a textbook appealing to them.Results: A total of 250 neurosurgeons at different levels of training responded to our questionnaire. Overall, “Rhoton’s Cranial Anatomy and Surgical Approach: Albert L. Rhoton Jr., Doctor of Medicine” was the most commonly chosen textbook that the neurosurgeons would use to revise neuroanatomy (86.0%;n= 215), recommend for residents (80.8%;n= 202) and recommend for certified surgeons (Continuing Medical Education (59.8%;n= 150), where applicable. “Illustrations” was rated as the most important neuroanatomy textbook quality by 53% (n= 134). “Rhoton collection” was the most popular online source (65.7%;n= 164.25). Chi-square tests showed no association between years of experience and the textbooks neurosurgeons recommended.Conclusion: Based on our study Rhoton’s book and his online collection are the leading neuroanatomy resources, recommended by neurosurgeons for neurosurgeons worldwide. The other selected resources can be implemented as a complementary part of a comprehensive neuroanatomy teaching curriculum. Knowing the relevance of these assets from a neurosurgeon’s perspective is valuable in directing future educational plan updates and recommendations.