# Unveiling the Unexpected: Co‐Occurrence of Brain Tumor and Spine Pathology Revealed After Spinal Surgery

## TL;DR

Three patients with cervical spondylotic myelopathy were found to have brain meningiomas after spinal surgery failed to improve their symptoms.

## Contribution

Highlights the importance of considering brain tumors in patients with atypical spinal symptoms and poor surgical outcomes.

## Key findings

- Three patients with CSM had no improvement after spinal surgery and were later found to have brain meningiomas.
- All tumors were WHO Grade I and resected, leading to neurological recovery.
- Brain MRI is recommended when spinal symptoms are atypical or unresolved after surgery.

## Abstract

Cervical spondylotic myelopathy (CSM) is a common cause of spinal cord dysfunction. Because its symptoms may resemble those of intracranial tumors, patients can be misdiagnosed and undergo inappropriate spinal procedures. We describe three patients initially treated with cervical decompression under the impression of CSM. In each case, neurological deficits failed to improve, or even progressed, despite adequate surgery. Further investigation with brain MRI disclosed large meningiomas located in the frontoparietal or parasagittal regions. All tumors were completely resected, pathology confirmed WHO Grade I meningioma, and the patients showed meaningful neurological recovery. These observations remind us that neurological findings must be interpreted in parallel with cervical imaging. A brain MRI should be obtained whenever clinical features are disproportionate to spinal pathology, extend beyond the usual pattern of myelopathy, or remain unresolved after decompression.