The epidemiology of meningiomas has been extensively studied, revealing significant associations with various demographic factors. A systematic review and meta-analysis highlighted a nearly tenfold increased prevalence of breast cancer in female patients with meningioma compared to the general population, suggesting a potential shared etiology (ref: Degeneffe doi.org/10.1001/jamanetworkopen.2023.18620/). The National Brain Tumour Registry of China provided crucial data on primary brain tumors diagnosed in 2019-2020, emphasizing the need for standardized pathological diagnoses to facilitate global epidemiological comparisons (ref: Xiao doi.org/10.1016/j.lanwpc.2023.100715/). Furthermore, a study exploring the joint impacts of sex and race/ethnicity on meningioma incidence found that older age, African-American race, and female sex are significant risk factors, with variations in incidence rates across tumor grades (ref: Walsh doi.org/10.1093/noajnl/). The increasing diagnosis of incidental meningiomas due to advanced imaging techniques poses management challenges, as many of these tumors are asymptomatic and may not require immediate intervention (ref: Islim doi.org/10.1093/noajnl/). Overall, the findings underscore the complexity of meningioma epidemiology and the necessity for further research into its risk factors and management strategies.

Clinical management of meningiomas has evolved, particularly with advancements in treatment modalities such as Pencil Beam Scanning Proton Therapy (PBS PT). A study assessing long-term outcomes in patients treated with PBS PT reported a median age of 50.4 years among 200 patients, with a significant proportion (70%) having WHO grade 1 tumors, highlighting the therapy's effectiveness in managing these cases (ref: Krcek doi.org/10.3390/cancers15123099/). Additionally, research on recurrence probabilities following radiotherapy for CNS WHO grade 2 meningiomas indicated that while radiotherapy is effective, some patients experience unexpectedly early recurrences, necessitating integrated molecular-morphologic classification for better prognostic accuracy (ref: Deng doi.org/10.1093/noajnl/). Fatigue, a common symptom among meningioma patients, was found to correlate with various patient, tumor, and treatment-related factors, emphasizing the need for comprehensive symptom management strategies (ref: Quach doi.org/10.1093/noajnl/). The management of multiple meningiomas presents unique challenges, as they can arise from sporadic, familial, or radiation-induced etiologies, requiring tailored approaches for effective treatment (ref: Fahlström doi.org/10.1093/noajnl/). These studies collectively highlight the importance of personalized treatment plans and the need for ongoing research into the long-term outcomes of various therapeutic interventions.

Recent molecular and genomic studies have provided valuable insights into the pathophysiology of meningiomas. A comprehensive genomic analysis revealed that current smokers exhibit a distinct mutation profile, with increased NOTCH2 mutations and downregulation of xenobiotic metabolic genes, suggesting a potential link between smoking and meningioma development (ref: Khan doi.org/10.1007/s11060-023-04359-7/). Furthermore, the expression of progesterone receptors in meningiomas was associated with increased transverse relaxation times, indicating potential implications for imaging and treatment strategies (ref: Li doi.org/10.1016/j.acra.2023.05.012/). The immune microenvironment's role in meningioma progression was also explored, identifying key immune cells and genes that could serve as diagnostic and therapeutic targets (ref: Chen doi.org/10.1016/j.wneu.2023.05.090/). These findings underscore the importance of integrating molecular insights into clinical practice to enhance diagnostic accuracy and therapeutic efficacy in meningioma management.

Radiological assessment plays a critical role in the diagnosis and management of meningiomas. A study utilizing whole-volume apparent diffusion coefficient (ADC) histogram analysis demonstrated its effectiveness in distinguishing between intracranial solitary fibrous tumors and transitional meningiomas, providing a non-invasive diagnostic tool that could inform treatment protocols (ref: Wang doi.org/10.3389/fonc.2023.1155162/). Additionally, the 'claw sign' was investigated as a potential aid in axial localization of peripherally located gliomas on MRI, enhancing the diagnostic accuracy for these challenging cases (ref: Glamann doi.org/10.1111/vru.13253/). The clinical and genomic features of seizures in meningiomas were also examined, revealing that a significant proportion of patients experience seizures due to cortical irritation or mass effect, which can impact their quality of life (ref: Dincer doi.org/10.1093/noajnl/). Moreover, ADC histogram analysis was validated as a promising method for differentiating microcystic meningiomas from solitary fibrous tumors, achieving high sensitivity and specificity (ref: Liu doi.org/10.1016/j.wneu.2023.06.073/). These advancements in imaging techniques highlight their critical role in enhancing diagnostic precision and guiding therapeutic decisions.

Quality of life (QoL) and patient-reported outcomes are increasingly recognized as essential components in the management of meningiomas. A study assessing QoL in patients treated with Pencil Beam Scanning Proton Therapy found that treatment significantly impacts long-term outcomes, with a focus on minimizing side effects and enhancing patient well-being (ref: Krcek doi.org/10.3390/cancers15123099/). Fatigue, a prevalent symptom among meningioma patients, was investigated for its association with various factors, revealing that understanding these relationships is crucial for developing effective management strategies (ref: Quach doi.org/10.1093/noajnl/). The impact of seizures on QoL was also highlighted, as a substantial proportion of meningioma patients experience seizures that can severely affect their daily functioning and overall quality of life (ref: Dincer doi.org/10.1093/noajnl/). Furthermore, the challenges posed by multiple meningiomas necessitate tailored approaches to address the unique needs of these patients, emphasizing the importance of individualized care plans (ref: Fahlström doi.org/10.1093/noajnl/). Collectively, these findings underscore the need for a holistic approach to meningioma management that prioritizes patient-reported outcomes and QoL.

Surgical techniques for meningioma resection have evolved significantly, with recent studies focusing on the challenges and outcomes associated with various approaches. A case series on petroclival region meningiomas highlighted the complexities of surgical management due to the proximity of critical neurovascular structures, with logistic regression identifying factors associated with postoperative complications and neurological deficits (ref: Nguyen doi.org/10.1227/ons.0000000000000791/). The endoscopic extended transsphenoidal approach has emerged as a promising technique for achieving radical resection of skull base tumors involving the cavernous sinus, although it presents unique risks and challenges (ref: Hanakita doi.org/10.1227/ons.0000000000000749/). Additionally, a study on the effects of preoperative steroid use indicated that chronic steroid therapy may influence postoperative morbidity and mortality, necessitating careful consideration in surgical planning (ref: Waqar doi.org/10.1016/j.bas.2023.101725/). The management of radiation-induced meningiomas, particularly in patients with a history of CNS radiotherapy, underscores the need for vigilance in monitoring and addressing potential complications (ref: Banos doi.org/10.1016/j.bas.2023.101719/). These innovations and findings highlight the importance of refining surgical techniques to optimize patient outcomes.

Complications following meningioma surgery remain a significant concern, with recent studies shedding light on various factors influencing postoperative outcomes. Research on the effects of preoperative steroids indicated that prolonged steroid use is associated with increased risks of complications following craniotomy, emphasizing the need for careful management of patients on chronic steroid therapy (ref: Waqar doi.org/10.1016/j.bas.2023.101725/). A case series focusing on petroclival region meningiomas revealed that surgical approach selection is critical, as factors such as previous surgeries and tumor location significantly impact the likelihood of postoperative neurological deficits (ref: Nguyen doi.org/10.1227/ons.0000000000000791/). Additionally, the challenges associated with endoscopic extended transsphenoidal surgery for tumors invading the cavernous sinus were highlighted, with findings suggesting that prior surgical history may complicate outcomes (ref: Hanakita doi.org/10.1227/ons.0000000000000749/). The risk of developing radiation-induced meningiomas in patients who underwent CNS radiotherapy further complicates postoperative care, necessitating ongoing monitoring and management strategies (ref: Banos doi.org/10.1016/j.bas.2023.101719/). These insights underscore the importance of a comprehensive approach to postoperative care that addresses potential complications and optimizes patient recovery.

The increasing use of advanced imaging techniques has led to a rise in incidental meningioma diagnoses, presenting unique management challenges. A study discussed the management of incidental meningiomas, noting that most are small and exhibit indolent behavior, often not requiring immediate intervention unless they cause neurological deficits or seizures (ref: Islim doi.org/10.1093/noajnl/). The joint impacts of demographic factors such as sex and race/ethnicity on meningioma incidence were explored, revealing significant variations in incidence rates across different tumor grades, which may inform management strategies (ref: Walsh doi.org/10.1093/noajnl/). The National Brain Tumour Registry of China's statistical report emphasized the need for standardized data collection to facilitate epidemiological comparisons and improve management approaches (ref: Xiao doi.org/10.1016/j.lanwpc.2023.100715/). Furthermore, ongoing clinical challenges in managing meningiomas were highlighted, with a call for future research to address these issues and improve patient outcomes (ref: Wang doi.org/10.1093/noajnl/). Collectively, these findings underscore the importance of developing tailored management strategies for incidental meningiomas and addressing the complexities of their clinical management.