Background: Seizures in the early postoperative period may impair patient recovery and increase the risk of complications. The aim of this study is to determine whether there is any advantage in postoperative seizure prophylaxis following meningioma resection. Methods: This systematic review was conducted in accordance with PRISMA guidelines. PUBMED, Web of Science, Embase, Science Direct, and Cochrane were searched for papers until April 2023. Results: Among nine studies, a total of 3249 patients were evaluated, of which 984 patients received antiepileptic drugs (AEDs). No significant difference was observed in the frequency of seizure events between patients who were treated with antiepileptic drugs (AEDs) and those who were not. (RR 1.22, 95% CI 0.66 to 2.40; I² = 57%). Postoperative seizures occurred in 5% (95% CI: 1% to 9%) within the early time period (7 days), with significant heterogeneity between the studies (I² = 91% and 97%, respectively). In seizure-naive patients, the rate of postoperative seizures was 2% (95% CI: 0% to 6%) in the early period and increased to 6% (95% CI: 0% to 15%) in the late period. High heterogeneity led to the use of random-effects models in all analyses. Conclusions: The current evidence does not provide sufficient support for the effectiveness of prophylactic AED medications in preventing postoperative seizures in patients undergoing meningioma resection. This underscores the importance of considering diagnostic criteria and conducting individual patient analysis to guide clinical decision-making in this context.

BACKGROUND AND OBJECTIVES: The greater occipital nerve (GON) and lesser occipital nerve (LON) have gained importance because of conditions such as occipital neuralgia and cervicogenic headaches. To a great depth, their anatomy is essential for performing viable diagnostic and therapeutic procedures such as nerve blocks and decompression procedures. This research involves identifying key anatomic landmarks and the potential compression points of the GON and LON using cadaveric dissections for possible surgical approaches. METHODS: Five fresh, untreated cadavers, 3 male and 2 female, were dissected bilaterally to trace the pathways of the GON and LON. Anatomic measurements were made using ImageJ software, and coordinates were analyzed with K-means clustering for optimal intervention points. These dissections focused on determining in detail the relation of these nerves to surrounding muscular and fascial structures. RESULTS: The study shows that for GON, there were many points possible for compression, such as where it pierced through the semispinalis and trapezius muscles along the course of the occipital artery. For the LON, however, the potential compression sites were contact points along the course of the occipital artery. After applying K-means clustering, 4 centroids (M1, M2, M3, and M4) were identified. M1 and M3 correspond to the LON, while M2 and M4 correspond to the GON. These centroid locations lie near the nerves' most common compression sites, suggesting they could serve as strategic landmarks for surgical approaches. Cluster quality measures (inertia and silhouette coefficients) showed well-defined clusters. CONCLUSION: This study yields anatomic information about the GON and LON anatomy and illustrates key compression points and optimal sites for therapeutic interventions. Within the constraints of sample size, these findings provide preliminary anatomic insights that can guide more precise nerve block and decompression techniques for occipital neuralgia and related headaches.