The authors present a rare case of cavernous angioma mimicking a meningioma in a 58-year-old man who presented with a headache and dizziness. There were no neurological deficits or other neurological symptoms or signs. An extra-axial mass lesion thought to be associated with diffusely well-enhanced falx in the postcontrast sections was noted in the posterior interhemispheric fissure near the posterior part of the corpus callosum splenium. Extra-axial cavernous angiomas (cavernomas) are extremely rare lesions. They most commonly occur in the parenchyma but have been occasionally reported to arise from the dura matter. Dural cavernous angiomas arise from dural sinuses, falx cerebri, tentorium cerebelli, cranial base dura, or internal auditory canal dura and convexity. Parenchymal cavernous angiomas classically have a ring of hemosiderin surrounding the lesions observed on magnetic resonance imaging, but dural cavernous angiomas do not display the same magnetic resonance imaging characteristics and occasionally exhibit a dural tail sign due to which they can often be misdiagnosed as meningiomas.

Objective : The aim of this study to investigate the benefits of patient-based 3-dimensional (3D) cerebral arteriovenous malformation (AVM) models for preoperative surgical planning and education.Methods : Fifteen patients were operated on for AVMs between 2015 and 2019 with patient-based 3D models. Ten patients’ preoperative cranial angiogram screenings were evaluated preoperatively or perioperatively via patient-based 3D models. Two patients needed emergent surgical intervention; their models were solely designed based on their AVMs and used during the operation. However, the other patients who underwent elective surgery had the modeling starting from the skull base. These models were used both preoperatively and perioperatively. The benefits of patients arising from treatment with these models were evaluated via patient files and radiological data.Results : Fifteen patients (10 males and five females) between 16 and 66 years underwent surgery. The mean age of the patients was 40.0±14.72. The most frequent symptom patients observed were headaches. Four patients had intracranial bleeding; the symptom of admission was a loss of consciousness. Two patients (13.3%) belonged to Spetzler-Martin (SM) grade I, four (26.7%) belonged to SM grade II, eight (53.3%) belonged to SM grade III, and one (6.7%) belonged to SM grade IV. The mean operation duration was 3.44±0.47 hours. Three patients (20%) developed transient neurologic deficits postoperatively, whereas three other patients died (20%).Conclusion : Several technological innovations have emerged in recent years to reduce undesired outcomes and support the surgical team. For example, 3D models have been employed in various surgical procedures in the last decade. The routine usage of patient-based 3D models will not only support better surgical planning and practice, but it will also be useful in educating assistants and explaining the situation to the patient as well.

Although intraparenchymal meningiomas have rarely been reported in the literature, the papillary type has been reported only as infratentorial. Here we report the case of a 21-year-old female patient with intraparenchymal lesion. To our knowledge, this case describes the first report of a patient with a supratentorial intraparenchymal papillary meningioma.

AIM: To uncover factors that can predict the development of C5 palsy before surgery by evaluating several different parameters.MATERIAL and METHODS: A total of 177 patients who underwent surgery between 2015 and 2020 were included in the study. In total, C5 palsy was observed in 22 (12.4%) of our patients. The radiological and clinical data of the patients were retrospectively analyzed and added to the data.RESULTS: A total of 177 patients who satisfied the criteria were included in the study, among whom 117 (66.1%) and 60 (33.9%) were male and female, respectively. Patients with ossified posterior longitudinal ligament (OPLL) (92; 52.0%) needed surgery the most. C5 palsy developed in 16/92 (17.3%) patients who had surgery for OPLL. This result was statistically significant (p<0.001). However, a significant difference in the postoperative Pavlov ratio was noted between both groups (p=0.027). The foraminal dimensions for the C5 palsy group were significantly lower than those for the non-C5 palsy group.CONCLUSION: Smaller C5 root foramina diameter measurements were the most important predictive factor for the development of C5 palsy after open-door cervical laminoplasty. Although the pathophysiology remains to be fully understood, ischemia-reperfusion injury supposedly plays a role therein.

Objectives: The Goel–Harms technique provides rapid stabilization and high fusion rates for atlantoaxial instability but carries a risk of neurovascular injury during lateral mass and pedicle screw insertion. Recently, 3D printing has emerged as a cost-effective and increasingly accessible tool in various surgical fields. This study aimed to compare the clinical and radiological outcomes of C1–C2 fixation using a 3D-printed template versus the free-hand technique. Methods: This retrospective cohort study included patients who underwent C1–C2 fixation with the Goel–Harms technique at two tertiary neurosurgical centers between 2021 and 2023. Operative, radiological, and functional outcomes were reviewed in 21 patients who were operated using either a patient-specific 3D-printed template applied intraoperatively (Group 1; n = 10) or the free-hand technique (Group 2; n = 11). Postoperative screw accuracy was assessed using the Gertzbein–Robbins classification. Results: A total of 84 screws were placed (Group 1: 40; Group 2: 44). In Group 1, 38 of 40 screws (95%) were accurately placed, compared with 41 of 44 screws (93.1%) in Group 2. The mean fluoroscopy and operative times were significantly shorter in Group 1 than in Group 2 (21.90 ± 4.33 s vs. 27.09 ± 13.48 s, p = 0.012; 126.60 ± 28.70 min vs. 171.36 ± 40.44 min, p = 0.010, respectively). Conclusions: The 3D-printed template technique significantly reduced operative and fluoroscopy times compared with the free-hand technique. Three-dimensional printing offers a cost-effective alternative to conventional navigation systems by eliminating their time-consuming preoperative setup in the operating room.