The optimal surgical approach for olfactory groove meningiomas (OGMs) remains debated. Comparisons between the endoscopic endonasal approach (EEA) and transcranial approach (TCA) are limited by confounding by indication, as tumor anatomy dictates approach selection. This meta-analysis synthesizes evidence while addressing these limitations. A systematic review and meta-analysis were conducted following PRISMA guidelines. PubMed, Embase, Web of Science, Scopus, and Cochrane Library were searched (2000-2024). Studies reporting EEA and TCA outcomes were included. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model, with heterogeneity assessed using I². Outcomes included gross total resection (GTR), visual outcomes, CSF leak, complications, and recurrence. Eight studies (n = 382) were included. Pooled analysis of 3 comparative studies showed no significant difference in GTR (OR: 0.71, 95% CI: 0.23-2.19, I² = 0%) or recurrence (OR: 1.63, 95% CI: 0.60-4.45, I² = 0%). EEA was associated with higher odds of CSF leak (OR: 5.36, 95% CI 1.64-17.5, I² = 0%). GTR rates ranged from 82%-96% for EEA and 86%-100% for TCA, while CSF leak rates were 16%-30% and 2%-7%, respectively. Visual outcomes were comparable or favored EEA. EEA was mainly used for smaller tumors, while TCA was used for larger lesions. Both approaches are effective, but comparisons are limited by selection bias. EEA carries a higher CSF leak risk, while GTR and recurrence are comparable. TCA achieves more consistent GTR in complex tumors. Approach selection should be individualized based on tumor anatomy and surgeon expertise.

Meningiomas are the most common intracranial tumors, but it's uncommon in the pediatric and adolescent populations. Pediatric meningiomas differ from adult meningiomas by a higher rate of malignant change, atypical location, male predominance and a higher recurrence rate. The most common presenting symptoms in supratentorial pediatric meningiomas are the signs and symptoms of high intracranial pressure (headache, vomiting, and nausea) and seizures. The most common presenting symptoms in infratentorial pediatric meningiomas are signs of cranial nerve deficits. Magnetic resonance imaging of the brain is the gold standard modality for diagnosis. The mainstay of management is surgical resection with the aim of gross total resection, as it is the strongest independent prognostic factor. In this report, we describe an extremely rare case of gradual onset, progressive motor developmental delay in a 21-month-old girl with a huge right frontotemporal meningioma that was treated with surgical resection that, to the best of our knowledge, is the youngest in the literature.

Background: Spontaneous spinal epidural hematomas (SSEHs) are a rare. Cervical SSEHs, though less common than thoracic or lumbar variants, pose a heightened risk of morbidity due to proximity to the brainstem and spinal cord making timely diagnosis treatment even more critical. Case Description: A 50-year-old female presented with chronic neck pain for 1 week presented with the rapid onset of a progressive quadriparesis. The cervical magnetic resonance imaging revealed a posterior SSEH extending from C4 to T2, with maximal cord compression at C6–C7; the radiological differential diagnosis favored epidural hematoma versus tumor. She underwent an urgent decompressive laminectomy for evacuation of hematoma; pathology revealed no neoplasia or vascular malformation. Postoperatively, she recovered marked neurological motor function. Conclusion: Cervical SSEHs are rare and require immediate magnetic resonance diagnosis and surgical decompression to optimize neurological recovery.

Background/Objectives: External ventricular drains (EVDs) are widely used in the management of intracranial hemorrhage and hydrocephalus; however, they carry a significant risk of device-related central nervous system infections, including ventriculitis and meningitis, which are associated with increased morbidity, mortality, and prolonged intensive care stays. We conducted a systematic review and meta-analysis to evaluate whether prolonged EVD duration (>10 days) is associated with an increased risk of ventriculostomy-related infection compared with shorter duration (≤10 days), and to explore the association with cerebrospinal fluid (CSF) leak where data were available. Methods: A comprehensive literature search of PubMed, Google Scholar, Web of Science, and Cochrane CENTRAL was performed from database inception through September 2025, including English-language clinical trials, cohort studies, and case–control studies reporting infection outcomes related to EVD management factors. Two reviewers independently screened studies and extracted data. A random-effects meta-analysis was conducted to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs). Results: Sixteen studies comprising approximately 5500 patients met the inclusion criteria. Shorter EVD duration (≤10 days) was associated with a significantly lower risk of infection (pooled OR 0.45, 95% CI 0.30–0.68; p = 0.0002), corresponding to a 55% reduction in the odds of ventriculostomy-related infection. Prolonged EVD duration was consistently associated with increased infection risk across studies. Conclusions:These findings suggest that minimizing EVD duration may reduce infection risk and support early removal when clinically feasible. However, given the observational nature of the included studies, the results should be interpreted with caution. Further research is warranted to evaluate additional modifiable risk factors, including CSF leakage and sampling practices.