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Meningiomas are leptomeningeal neoplasms thought to originate from arachnoid membranes that form the cranial and spinal meninges ¹⁾.

• Prehistoric evidence: Trepanned skulls from ancient Egypt and Peru show bone changes suggestive of slowly growing intracranial tumors.
• 7th century – Paul of Aegina: Described cranial masses possibly corresponding to meningiomas, noting their local expansion and compressive effects.

• 1833 – Jean Cruveilhier:
  • Provided early pathological illustrations of dural-based tumors.
  • Identified their expansive but typically non-invasive nature.
• 1887 – Sir William Macewen:
  • Performed one of the first successful surgical removals of an intracranial tumor compatible with meningioma.
• 1891 – Francesco Durante:
  • Reported resection of a parasagittal meningioma.
  • Pioneered surgical techniques for cranial tumors.

• 1922 – Harvey Cushing:
  • Introduced the term *meningioma*.
  • Distinguished these tumors from gliomas and other intracranial neoplasms.
  • Developed surgical approaches and a preliminary classification based on clinical and pathological features.

• 1930s–1950s:
  • Use of pneumoencephalography and cerebral angiography to localize tumors.
• 1970s:
  • Introduction of Computed Tomography (CT).
• 1980s–1990s:
  • Magnetic Resonance Imaging (MRI) improved non-invasive diagnosis and preoperative planning.

• 1993 – WHO Classification:
  • Meningiomas classified into Grade I (benign), Grade II (atypical), and Grade III (anaplastic/malignant).
• Updated classifications:
  • Revisions in 2000, 2007, 2016, and 2021 incorporate molecular markers.

• NF2 gene mutations:
  • Found in ~50% of sporadic meningiomas.
• Other genetic alterations:
  • TRAF7, KLF4, AKT1, SMO, and PIK3CA mutations identified.
• 2020s:
  • Molecular profiling influences prognosis and guides emerging targeted therapies.

• Multimodal approach:
  • Observation, microsurgery, stereotactic radiosurgery, conventional radiotherapy.
  • Clinical trials investigating immunotherapy and targeted therapies.
• Personalized medicine:
  • Tumor genetics and radiogenomics support individualized treatment plans.

Note: This page summarizes the key historical milestones in the understanding, diagnosis, and treatment of meningiomas.

Written with Louise Eisenhardt and published in 1938, Meningiomas is a monograph of incredible description and detail. The meticulous categorization of meningiomas, their presentation, clinical outcome, and surgical therapies are even further supplemented by Cushing's personal commentary, questions, and recollections. Cushing's genius was evident in his ability not only to make insightful clinical observations, but also to synthesize these ideas within the neurosurgical context of his era. As he says in Meningiomas, “Thus the pathological curiosity of one day becomes in its proper time a commonplace… most of which are one and the same disorder–had, for their interpretation, to await the advent of the Neurosurgeon ²⁾.

Meningioma epidemiology.

Meningioma classification.

see Meningioma cell lines.

Meningioma immune response

see Meningioma etiology.

see Meningioma Pathogenesis.

Meningioma clinical features.

see Meningioma Diagnosis.

see Meningioma differential diagnosis.

see Meningioma treatment.

see Meningioma outcome.

see Meningioma metastases.

see Meningioma recurrence.

see Simpson grading system.

Meningioma Systematic reviews.

In November 2016, Almutairi et al. performed a title-specific search of the Scopus database using “Meningioma” as the search query term without publication date restrictions. The top 100 most cited articles were obtained and reviewed.

The top 100 most cited articles received a mean 198 citations per paper. Publication dates ranged from 1953 to 2013; most articles were published between 1994 and 2003, with 50 articles published during that period. NEUROSURGERY published the greatest number of top cited articles (22 of 100). The most frequent study categories were laboratorial studies (31 of 100) and natural history studies (28 of 100). Non-operative management studies were twice as common as operative management studies in the top cited articles. Neurosurgery as a specialty contributed to 50% of the top 100 list. The most contributing institute was the Mayo Clinic (11%); the majority of the top cited articles originated in the United States (53%).

They identified the top 100 most-cited articles on meningioma that may be considered significant and impactful works, as well as the most noteworthy. Additionally, they recognized the historical development and advances in meningioma research, and the important contributions of various authors, specialty fields, and countries. A large proportion of the most cited articles were written by authors other than neurosurgeons, and many of these articles were published in non-neurosurgery journals ³⁾.

Meningioma case series.