{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T09:03:01Z","timestamp":1780131781843,"version":"3.54.0"},"reference-count":60,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,6]]},"abstract":"\n Meningiomas are among the most common intracranial pathological conditions, accounting for 36% of intracranial lesions treated by neurosurgeons. Although the majority of these lesions are benign, the classical categorization of tumors by histological type or World Health Organization (WHO) grade has not fully captured the potential for meningioma progression and recurrence. Many targeted treatments have failed to generate a long-lasting effect on these tumors. Recently, several seminal studies evaluating the genomics of intracranial meningiomas have rapidly changed the understanding of the disease. The importance of\n NF2<\/jats:italic>\n (neurofibromin 2),\n TRAF7<\/jats:italic>\n (tumor necrosis factor [TNF] receptor\u2013associated factor 7),\n KLF4<\/jats:italic>\n (Kruppel-like factor 4),\n AKT1<\/jats:italic>\n ,\n SMO<\/jats:italic>\n (smoothened),\n PIK3CA<\/jats:italic>\n (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha), and\n POLR2<\/jats:italic>\n (RNA polymerase II subunit A) demonstrates that there are at least 6 distinct mutational classes of meningiomas. In addition, 6 methylation classes of meningioma have been appreciated, enabling improved prediction of prognosis compared with traditional WHO grades. Genomic studies have shed light on the nature of recurrent meningioma, distinct intracranial locations and mutational patterns, and a potential embryonic cancer stem cell\u2013like origin. However, despite these exciting findings, the clinical relevance of these findings remains elusive. The authors review the key findings from recent genomic studies in meningiomas, specifically focusing on how these findings relate to clinical insights for the practicing neurosurgeon.\n <\/jats:p>","DOI":"10.3171\/2018.2.focus1849","type":"journal-article","created":{"date-parts":[[2018,6,1]],"date-time":"2018-06-01T03:36:59Z","timestamp":1527824219000},"page":"E10","source":"Crossref","is-referenced-by-count":40,"title":["Clinical potential of meningioma genomic insights: a practical review for neurosurgeons"],"prefix":"10.3171","volume":"44","author":[{"given":"Michael","family":"Karsy","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed A.","family":"Azab","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussam","family":"Abou-Al-Shaar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilyas","family":"Eli","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randy L.","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, and"},{"name":"Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. Ryan","family":"Ormond","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Acta Neurochir (Wien)","first-page":"447","article-title":"Gene expression profiling of meningiomas: current status after a decade of microarray-based transcriptomic studies","volume":"153","author":"Aarhus M","year":"2011","unstructured":"Aarhus M, Lund-Johansen M, Knappskog PM: Gene expression profiling of meningiomas: current status after a decade of microarray-based transcriptomic studies. Acta Neurochir (Wien) 153:447\u2013456, 2011"},{"key":"b2","series-title":"Neuro Oncol","first-page":"649","article-title":"Oncogenic PI3K mutations are as common as AKT1 and SMO mutations in meningioma","volume":"18","author":"Abedalthagafi M","year":"2016","unstructured":"Abedalthagafi M, Bi WL, Aizer AA, Merrill PH, Brewster R, Agarwalla PK, : Oncogenic PI3K mutations are as common as AKT1 and SMO mutations in meningioma. Neuro Oncol 18:649\u2013655, 2016"},{"key":"b3","series-title":"J Neurosurg","first-page":"525","article-title":"Genomic landscape of intracranial meningiomas","volume":"125","author":"Bi WL","year":"2016","unstructured":"Bi WL, Abedalthagafi M, Horowitz P, Agarwalla PK, Mei Y, Aizer AA, : Genomic landscape of intracranial meningiomas. J Neurosurg 125:525\u2013535, 2016"},{"key":"b4","series-title":"NPJ Genom Med","first-page":"15","article-title":"Genomic landscape of high-grade meningiomas","volume":"2","author":"Bi WL","year":"2017","unstructured":"Bi WL, Greenwald NF, Abedalthagafi M, Wala J, Gibson WJ, Agarwalla PK, : Genomic landscape of high-grade meningiomas. NPJ Genom Med 2:15, 2017"},{"key":"b5","series-title":"Nat Genet","first-page":"285","article-title":"Genomic sequencing of meningiomas identifies oncogenic SMO and AKT1 mutations","volume":"45","author":"Brastianos PK","year":"2013","unstructured":"Brastianos PK, Horowitz PM, Santagata S, Jones RT, McKenna A, Getz G, : Genomic sequencing of meningiomas identifies oncogenic SMO and AKT1 mutations. Nat Genet 45:285\u2013289, 2013"},{"key":"b6","series-title":"Science","first-page":"1077","article-title":"Genomic analysis of non-NF2 meningiomas reveals mutations in TRAF7, KLF4, AKT1, and SMO","volume":"339","author":"Clark VE","year":"2013","unstructured":"Clark VE, Erson-Omay EZ, Serin A, Yin J, Cotney J, Ozduman K, : Genomic analysis of non-NF2 meningiomas reveals mutations in TRAF7, KLF4, AKT1, and SMO. Science 339:1077\u20131080, 2013"},{"key":"b7","series-title":"Nat Genet","first-page":"1253","article-title":"Recurrent somatic mutations in POLR2A define a distinct subset of meningiomas","volume":"48","author":"Clark VE","year":"2016","unstructured":"Clark VE, Harmanc\u0131 AS, Bai H, Youngblood MW, Lee TI, Baranoski JF, : Recurrent somatic mutations in POLR2A define a distinct subset of meningiomas. Nat Genet 48:1253\u20131259, 2016"},{"key":"b8","series-title":"PLoS One","first-page":"e0187908","article-title":"Radiographic prediction of meningioma grade by semantic and radiomic features","volume":"12","author":"Coroller TP","year":"2017","unstructured":"Coroller TP, Bi WL, Huynh E, Abedalthagafi M, Aizer AA, Greenwald NF, : Radiographic prediction of meningioma grade by semantic and radiomic features. PLoS One 12:e0187908, 2017"},{"key":"b9","series-title":"Neurosurgery","first-page":"839","article-title":"Diagnostic value of fractal analysis for the differentiation of brain tumors using 3-Tesla magnetic resonance susceptibility-weighted imaging","volume":"79","author":"Di Ieva A","year":"2016","unstructured":"Di Ieva A, Le Reste PJ, Carsin-Nicol B, Ferre JC, Cusimano MD: Diagnostic value of fractal analysis for the differentiation of brain tumors using 3-Tesla magnetic resonance susceptibility-weighted imaging. Neurosurgery 79:839\u2013846, 2016"},{"key":"b10","series-title":"Lancet Oncol","first-page":"e383","article-title":"EANO guidelines for the diagnosis and treatment of meningiomas","volume":"17","author":"Goldbrunner R","year":"2016","unstructured":"Goldbrunner R, Minniti G, Preusser M, Jenkinson MD, Sallabanda K, Houdart E, : EANO guidelines for the diagnosis and treatment of meningiomas. Lancet Oncol 17:e383\u2013e391, 2016"},{"key":"b11","series-title":"Nat Cell Biol","first-page":"27","article-title":"The tumour-suppressor genes NF2\/Merlin and Expanded act through Hippo signalling to regulate cell proliferation and apoptosis","volume":"8","author":"Hamaratoglu F","year":"2006","unstructured":"Hamaratoglu F, Willecke M, Kango-Singh M, Nolo R, Hyun E, Tao C, : The tumour-suppressor genes NF2\/Merlin and Expanded act through Hippo signalling to regulate cell proliferation and apoptosis. Nat Cell Biol 8:27\u201336, 2006"},{"key":"b12","series-title":"Mol Cell Biol","first-page":"4250","article-title":"NF2\/merlin is a novel negative regulator of mTOR complex 1, and activation of mTORC1 is associated with meningioma and schwannoma growth","volume":"29","author":"James MF","year":"2009","unstructured":"James MF, Han S, Polizzano C, Plotkin SR, Manning BD, Stemmer-Rachamimov AO, : NF2\/merlin is a novel negative regulator of mTOR complex 1, and activation of mTORC1 is associated with meningioma and schwannoma growth. Mol Cell Biol 29:4250\u20134261, 2009"},{"key":"b13","series-title":"Mol Cancer Res","first-page":"649","article-title":"Regulation of mTOR complex 2 signaling in neurofibromatosis 2-deficient target cell types","volume":"10","author":"James MF","year":"2012","unstructured":"James MF, Stivison E, Beauchamp R, Han S, Li H, Wallace MR, : Regulation of mTOR complex 2 signaling in neurofibromatosis 2-deficient target cell types. Mol Cancer Res 10:649\u2013659, 2012"},{"key":"b14","series-title":"Neurosurgery","first-page":"146","article-title":"Predicting outcomes of patients with intracranial meningiomas using molecular markers of hypoxia, vascularity, and proliferation","volume":"71","author":"Jensen R","year":"2012","unstructured":"Jensen R, Lee J: Predicting outcomes of patients with intracranial meningiomas using molecular markers of hypoxia, vascularity, and proliferation. Neurosurgery 71:146\u2013156, 2012"},{"key":"b15","series-title":"J Neurosurg","first-page":"657","article-title":"Microvascularization of Grade I meningiomas: effect on tumor volume, blood loss, and patient outcome","volume":"128","author":"Karsy M","year":"2018","unstructured":"Karsy M, Burnett B, Di Ieva A, Cusimano MD, Jensen RL: Microvascularization of Grade I meningiomas: effect on tumor volume, blood loss, and patient outcome. J Neurosurg 128:657\u2013666, 2018"},{"key":"b16","series-title":"Neurosurg Clin N Am","first-page":"249","article-title":"Medical management of meningiomas: current status, failed treatments, and promising horizons","volume":"27","author":"Karsy M","year":"2016","unstructured":"Karsy M, Guan J, Cohen A, Colman H, Jensen RL: Medical management of meningiomas: current status, failed treatments, and promising horizons. Neurosurg Clin N Am 27:249\u2013260, 2016"},{"key":"b17","series-title":"World Neurosurg","first-page":"210","article-title":"Combined hydroxyurea and verapamil in the clinical treatment of refractory meningioma: human and orthotopic xenograft studies","volume":"86","author":"Karsy M","year":"2016","unstructured":"Karsy M, Hoang N, Barth T, Burt L, Dunson W, Gillespie DL, : Combined hydroxyurea and verapamil in the clinical treatment of refractory meningioma: human and orthotopic xenograft studies. World Neurosurg 86:210\u2013219, 2016"},{"key":"b18","series-title":"Acta Neuropathol","first-page":"803","article-title":"The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary","volume":"131","author":"Louis DN","year":"2016","unstructured":"Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, : The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol 131:803\u2013820, 2016"},{"key":"b19","series-title":"Cell Commun Signal","first-page":"34","article-title":"Osteoglycin promotes meningioma development through downregulation of NF2 and activation of mTOR signaling","volume":"15","author":"Mei Y","year":"2017","unstructured":"Mei Y, Du Z, Hu C, Greenwald NF, Abedalthagafi M, Agar NYR, : Osteoglycin promotes meningioma development through downregulation of NF2 and activation of mTOR signaling. Cell Commun Signal 15:34, 2017"},{"key":"b20","series-title":"Cancer Res","first-page":"520","article-title":"Merlin\/neurofibromatosis type 2 suppresses growth by inhibiting the activation of Ras and Rac","volume":"67","author":"Morrison H","year":"2007","unstructured":"Morrison H, Sperka T, Manent J, Giovannini M, Ponta H, Herrlich P: Merlin\/neurofibromatosis type 2 suppresses growth by inhibiting the activation of Ras and Rac. Cancer Res 67:520\u2013527, 2007"},{"issue":"Suppl 4","key":"b21","series-title":"Neuro Oncol","first-page":"iv1","article-title":"CBTRUS Statistical Report: Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2008\u20132012","volume":"17","author":"Ostrom QT","year":"2015","unstructured":"Ostrom QT, Gittleman H, Fulop J, Liu M, Blanda R, Kromer C, : CBTRUS Statistical Report: Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2008\u20132012. Neuro Oncol 17 (Suppl 4):iv1\u2013iv62, 2015"},{"issue":"5","key":"b22","series-title":"Neurosurg Focus","first-page":"E7","article-title":"Molecular genetics of meningiomas: a systematic review of the current literature and potential basis for future treatment paradigms","volume":"30","author":"Pham MH","year":"2011","unstructured":"Pham MH, Zada G, Mosich GM, Chen TC, Giannotta SL, Wang K, : Molecular genetics of meningiomas: a systematic review of the current literature and potential basis for future treatment paradigms. Neurosurg Focus 30(5):E7, 2011"},{"key":"b23","series-title":"Nat Rev Neurol","first-page":"106","article-title":"Advances in meningioma genetics: novel therapeutic opportunities","volume":"14","author":"Preusser M","year":"2018","unstructured":"Preusser M, Brastianos PK, Mawrin C: Advances in meningioma genetics: novel therapeutic opportunities. Nat Rev Neurol 14:106\u2013115, 2018"},{"key":"b24","series-title":"J Neurooncol","first-page":"315","article-title":"Aberrant signaling pathways in meningiomas","volume":"99","author":"Ragel BT","year":"2010","unstructured":"Ragel BT, Jensen RL: Aberrant signaling pathways in meningiomas. J Neurooncol 99:315\u2013324, 2010"},{"issue":"5","key":"b25","series-title":"Neurosurg Focus","first-page":"E9","article-title":"Molecular genetics of meningiomas","volume":"19","author":"Ragel BT","year":"2005","unstructured":"Ragel BT, Jensen RL: Molecular genetics of meningiomas. Neurosurg Focus 19(5):E9, 2005"},{"key":"b26","series-title":"Proc Natl Acad Sci U S A","first-page":"18200","article-title":"Neurofibromatosis 2 (NF2) tumor suppressor merlin inhibits phosphatidylinositol 3-kinase through binding to PIKE-L","volume":"101","author":"Rong R","year":"2004","unstructured":"Rong R, Tang X, Gutmann DH, Ye K: Neurofibromatosis 2 (NF2) tumor suppressor merlin inhibits phosphatidylinositol 3-kinase through binding to PIKE-L. Proc Natl Acad Sci U S A 101:18200\u201318205, 2004"},{"key":"b27","series-title":"Lancet Oncol","first-page":"682","article-title":"DNA methylation-based classification and grading system for meningioma: a multicentre, retrospective analysis","volume":"18","author":"Sahm F","year":"2017","unstructured":"Sahm F, Schrimpf D, Stichel D, Jones DTW, Hielscher T, Schefzyk S, : DNA methylation-based classification and grading system for meningioma: a multicentre, retrospective analysis. Lancet Oncol 18:682\u2013694, 2017"},{"key":"b28","series-title":"Neurosurg Clin N Am","first-page":"145","article-title":"Predicting meningioma consistency on preoperative neuroimaging studies","volume":"27","author":"Shiroishi MS","year":"2016","unstructured":"Shiroishi MS, Cen SY, Tamrazi B, D\u2019Amore F, Lerner A, King KS, : Predicting meningioma consistency on preoperative neuroimaging studies. Neurosurg Clin N Am 27:145\u2013154, 2016"},{"key":"b29","series-title":"J Neurosurg","first-page":"787","article-title":"Harvey Cushing\u2019s Meningiomas text and the historical origin of resectability criteria for the anterior one third of the superior sagittal sinus","volume":"99","author":"Shrivastava RK","year":"2003","unstructured":"Shrivastava RK, Segal S, Camins MB, Sen C, Post KD: Harvey Cushing\u2019s Meningiomas text and the historical origin of resectability criteria for the anterior one third of the superior sagittal sinus. J Neurosurg 99:787\u2013791, 2003"},{"key":"b30","series-title":"Neurosurg Rev","article-title":"Can MRI predict meningioma consistency?: a correlation with tumor pathology and systematic review","author":"Yao A","unstructured":"Yao A, Pain M, Balchandani P, Shrivastava RK: Can MRI predict meningioma consistency?: a correlation with tumor pathology and systematic review. Neurosurg Rev [epub ahead of print], 2016"},{"key":"b1","series-title":"Acta Neurochir (Wien)","first-page":"447","article-title":"Gene expression profiling of meningiomas: current status after a decade of microarray-based transcriptomic studies","volume":"153","author":"Aarhus M","year":"2011","unstructured":"Aarhus M, Lund-Johansen M, Knappskog PM: Gene expression profiling of meningiomas: current status after a decade of microarray-based transcriptomic studies. Acta Neurochir (Wien) 153:447\u2013456, 2011"},{"key":"b2","series-title":"Neuro Oncol","first-page":"649","article-title":"Oncogenic PI3K mutations are as common as AKT1 and SMO mutations in meningioma","volume":"18","author":"Abedalthagafi M","year":"2016","unstructured":"Abedalthagafi M, Bi WL, Aizer AA, Merrill PH, Brewster R, Agarwalla PK, : Oncogenic PI3K mutations are as common as AKT1 and SMO mutations in meningioma. Neuro Oncol 18:649\u2013655, 2016"},{"key":"b3","series-title":"J Neurosurg","first-page":"525","article-title":"Genomic landscape of intracranial meningiomas","volume":"125","author":"Bi WL","year":"2016","unstructured":"Bi WL, Abedalthagafi M, Horowitz P, Agarwalla PK, Mei Y, Aizer AA, : Genomic landscape of intracranial meningiomas. J Neurosurg 125:525\u2013535, 2016"},{"key":"b4","series-title":"NPJ Genom Med","first-page":"15","article-title":"Genomic landscape of high-grade meningiomas","volume":"2","author":"Bi WL","year":"2017","unstructured":"Bi WL, Greenwald NF, Abedalthagafi M, Wala J, Gibson WJ, Agarwalla PK, : Genomic landscape of high-grade meningiomas. NPJ Genom Med 2:15, 2017"},{"key":"b5","series-title":"Nat Genet","first-page":"285","article-title":"Genomic sequencing of meningiomas identifies oncogenic SMO and AKT1 mutations","volume":"45","author":"Brastianos PK","year":"2013","unstructured":"Brastianos PK, Horowitz PM, Santagata S, Jones RT, McKenna A, Getz G, : Genomic sequencing of meningiomas identifies oncogenic SMO and AKT1 mutations. Nat Genet 45:285\u2013289, 2013"},{"key":"b6","series-title":"Science","first-page":"1077","article-title":"Genomic analysis of non-NF2 meningiomas reveals mutations in TRAF7, KLF4, AKT1, and SMO","volume":"339","author":"Clark VE","year":"2013","unstructured":"Clark VE, Erson-Omay EZ, Serin A, Yin J, Cotney J, Ozduman K, : Genomic analysis of non-NF2 meningiomas reveals mutations in TRAF7, KLF4, AKT1, and SMO. Science 339:1077\u20131080, 2013"},{"key":"b7","series-title":"Nat Genet","first-page":"1253","article-title":"Recurrent somatic mutations in POLR2A define a distinct subset of meningiomas","volume":"48","author":"Clark VE","year":"2016","unstructured":"Clark VE, Harmanc\u0131 AS, Bai H, Youngblood MW, Lee TI, Baranoski JF, : Recurrent somatic mutations in POLR2A define a distinct subset of meningiomas. Nat Genet 48:1253\u20131259, 2016"},{"key":"b8","series-title":"PLoS One","first-page":"e0187908","article-title":"Radiographic prediction of meningioma grade by semantic and radiomic features","volume":"12","author":"Coroller TP","year":"2017","unstructured":"Coroller TP, Bi WL, Huynh E, Abedalthagafi M, Aizer AA, Greenwald NF, : Radiographic prediction of meningioma grade by semantic and radiomic features. PLoS One 12:e0187908, 2017"},{"key":"b9","series-title":"Neurosurgery","first-page":"839","article-title":"Diagnostic value of fractal analysis for the differentiation of brain tumors using 3-Tesla magnetic resonance susceptibility-weighted imaging","volume":"79","author":"Di Ieva A","year":"2016","unstructured":"Di Ieva A, Le Reste PJ, Carsin-Nicol B, Ferre JC, Cusimano MD: Diagnostic value of fractal analysis for the differentiation of brain tumors using 3-Tesla magnetic resonance susceptibility-weighted imaging. Neurosurgery 79:839\u2013846, 2016"},{"key":"b10","series-title":"Lancet Oncol","first-page":"e383","article-title":"EANO guidelines for the diagnosis and treatment of meningiomas","volume":"17","author":"Goldbrunner R","year":"2016","unstructured":"Goldbrunner R, Minniti G, Preusser M, Jenkinson MD, Sallabanda K, Houdart E, : EANO guidelines for the diagnosis and treatment of meningiomas. Lancet Oncol 17:e383\u2013e391, 2016"},{"key":"b11","series-title":"Nat Cell Biol","first-page":"27","article-title":"The tumour-suppressor genes NF2\/Merlin and Expanded act through Hippo signalling to regulate cell proliferation and apoptosis","volume":"8","author":"Hamaratoglu F","year":"2006","unstructured":"Hamaratoglu F, Willecke M, Kango-Singh M, Nolo R, Hyun E, Tao C, : The tumour-suppressor genes NF2\/Merlin and Expanded act through Hippo signalling to regulate cell proliferation and apoptosis. Nat Cell Biol 8:27\u201336, 2006"},{"key":"b12","series-title":"Mol Cell Biol","first-page":"4250","article-title":"NF2\/merlin is a novel negative regulator of mTOR complex 1, and activation of mTORC1 is associated with meningioma and schwannoma growth","volume":"29","author":"James MF","year":"2009","unstructured":"James MF, Han S, Polizzano C, Plotkin SR, Manning BD, Stemmer-Rachamimov AO, : NF2\/merlin is a novel negative regulator of mTOR complex 1, and activation of mTORC1 is associated with meningioma and schwannoma growth. Mol Cell Biol 29:4250\u20134261, 2009"},{"key":"b13","series-title":"Mol Cancer Res","first-page":"649","article-title":"Regulation of mTOR complex 2 signaling in neurofibromatosis 2-deficient target cell types","volume":"10","author":"James MF","year":"2012","unstructured":"James MF, Stivison E, Beauchamp R, Han S, Li H, Wallace MR, : Regulation of mTOR complex 2 signaling in neurofibromatosis 2-deficient target cell types. Mol Cancer Res 10:649\u2013659, 2012"},{"key":"b14","series-title":"Neurosurgery","first-page":"146","article-title":"Predicting outcomes of patients with intracranial meningiomas using molecular markers of hypoxia, vascularity, and proliferation","volume":"71","author":"Jensen R","year":"2012","unstructured":"Jensen R, Lee J: Predicting outcomes of patients with intracranial meningiomas using molecular markers of hypoxia, vascularity, and proliferation. Neurosurgery 71:146\u2013156, 2012"},{"key":"b15","series-title":"J Neurosurg","first-page":"657","article-title":"Microvascularization of Grade I meningiomas: effect on tumor volume, blood loss, and patient outcome","volume":"128","author":"Karsy M","year":"2018","unstructured":"Karsy M, Burnett B, Di Ieva A, Cusimano MD, Jensen RL: Microvascularization of Grade I meningiomas: effect on tumor volume, blood loss, and patient outcome. J Neurosurg 128:657\u2013666, 2018"},{"key":"b16","series-title":"Neurosurg Clin N Am","first-page":"249","article-title":"Medical management of meningiomas: current status, failed treatments, and promising horizons","volume":"27","author":"Karsy M","year":"2016","unstructured":"Karsy M, Guan J, Cohen A, Colman H, Jensen RL: Medical management of meningiomas: current status, failed treatments, and promising horizons. Neurosurg Clin N Am 27:249\u2013260, 2016"},{"key":"b17","series-title":"World Neurosurg","first-page":"210","article-title":"Combined hydroxyurea and verapamil in the clinical treatment of refractory meningioma: human and orthotopic xenograft studies","volume":"86","author":"Karsy M","year":"2016","unstructured":"Karsy M, Hoang N, Barth T, Burt L, Dunson W, Gillespie DL, : Combined hydroxyurea and verapamil in the clinical treatment of refractory meningioma: human and orthotopic xenograft studies. World Neurosurg 86:210\u2013219, 2016"},{"key":"b18","series-title":"Acta Neuropathol","first-page":"803","article-title":"The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary","volume":"131","author":"Louis DN","year":"2016","unstructured":"Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, : The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol 131:803\u2013820, 2016"},{"key":"b19","series-title":"Cell Commun Signal","first-page":"34","article-title":"Osteoglycin promotes meningioma development through downregulation of NF2 and activation of mTOR signaling","volume":"15","author":"Mei Y","year":"2017","unstructured":"Mei Y, Du Z, Hu C, Greenwald NF, Abedalthagafi M, Agar NYR, : Osteoglycin promotes meningioma development through downregulation of NF2 and activation of mTOR signaling. Cell Commun Signal 15:34, 2017"},{"key":"b20","series-title":"Cancer Res","first-page":"520","article-title":"Merlin\/neurofibromatosis type 2 suppresses growth by inhibiting the activation of Ras and Rac","volume":"67","author":"Morrison H","year":"2007","unstructured":"Morrison H, Sperka T, Manent J, Giovannini M, Ponta H, Herrlich P: Merlin\/neurofibromatosis type 2 suppresses growth by inhibiting the activation of Ras and Rac. Cancer Res 67:520\u2013527, 2007"},{"issue":"Suppl 4","key":"b21","series-title":"Neuro Oncol","first-page":"iv1","article-title":"CBTRUS Statistical Report: Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2008\u20132012","volume":"17","author":"Ostrom QT","year":"2015","unstructured":"Ostrom QT, Gittleman H, Fulop J, Liu M, Blanda R, Kromer C, : CBTRUS Statistical Report: Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2008\u20132012. Neuro Oncol 17 (Suppl 4):iv1\u2013iv62, 2015"},{"issue":"5","key":"b22","series-title":"Neurosurg Focus","first-page":"E7","article-title":"Molecular genetics of meningiomas: a systematic review of the current literature and potential basis for future treatment paradigms","volume":"30","author":"Pham MH","year":"2011","unstructured":"Pham MH, Zada G, Mosich GM, Chen TC, Giannotta SL, Wang K, : Molecular genetics of meningiomas: a systematic review of the current literature and potential basis for future treatment paradigms. Neurosurg Focus 30(5):E7, 2011"},{"key":"b23","series-title":"Nat Rev Neurol","first-page":"106","article-title":"Advances in meningioma genetics: novel therapeutic opportunities","volume":"14","author":"Preusser M","year":"2018","unstructured":"Preusser M, Brastianos PK, Mawrin C: Advances in meningioma genetics: novel therapeutic opportunities. Nat Rev Neurol 14:106\u2013115, 2018"},{"key":"b24","series-title":"J Neurooncol","first-page":"315","article-title":"Aberrant signaling pathways in meningiomas","volume":"99","author":"Ragel BT","year":"2010","unstructured":"Ragel BT, Jensen RL: Aberrant signaling pathways in meningiomas. J Neurooncol 99:315\u2013324, 2010"},{"issue":"5","key":"b25","series-title":"Neurosurg Focus","first-page":"E9","article-title":"Molecular genetics of meningiomas","volume":"19","author":"Ragel BT","year":"2005","unstructured":"Ragel BT, Jensen RL: Molecular genetics of meningiomas. Neurosurg Focus 19(5):E9, 2005"},{"key":"b26","series-title":"Proc Natl Acad Sci U S A","first-page":"18200","article-title":"Neurofibromatosis 2 (NF2) tumor suppressor merlin inhibits phosphatidylinositol 3-kinase through binding to PIKE-L","volume":"101","author":"Rong R","year":"2004","unstructured":"Rong R, Tang X, Gutmann DH, Ye K: Neurofibromatosis 2 (NF2) tumor suppressor merlin inhibits phosphatidylinositol 3-kinase through binding to PIKE-L. Proc Natl Acad Sci U S A 101:18200\u201318205, 2004"},{"key":"b27","series-title":"Lancet Oncol","first-page":"682","article-title":"DNA methylation-based classification and grading system for meningioma: a multicentre, retrospective analysis","volume":"18","author":"Sahm F","year":"2017","unstructured":"Sahm F, Schrimpf D, Stichel D, Jones DTW, Hielscher T, Schefzyk S, : DNA methylation-based classification and grading system for meningioma: a multicentre, retrospective analysis. Lancet Oncol 18:682\u2013694, 2017"},{"key":"b28","series-title":"Neurosurg Clin N Am","first-page":"145","article-title":"Predicting meningioma consistency on preoperative neuroimaging studies","volume":"27","author":"Shiroishi MS","year":"2016","unstructured":"Shiroishi MS, Cen SY, Tamrazi B, D\u2019Amore F, Lerner A, King KS, : Predicting meningioma consistency on preoperative neuroimaging studies. Neurosurg Clin N Am 27:145\u2013154, 2016"},{"key":"b29","series-title":"J Neurosurg","first-page":"787","article-title":"Harvey Cushing\u2019s Meningiomas text and the historical origin of resectability criteria for the anterior one third of the superior sagittal sinus","volume":"99","author":"Shrivastava RK","year":"2003","unstructured":"Shrivastava RK, Segal S, Camins MB, Sen C, Post KD: Harvey Cushing\u2019s Meningiomas text and the historical origin of resectability criteria for the anterior one third of the superior sagittal sinus. J Neurosurg 99:787\u2013791, 2003"},{"key":"b30","series-title":"Neurosurg Rev","article-title":"Can MRI predict meningioma consistency?: a correlation with tumor pathology and systematic review","author":"Yao A","unstructured":"Yao A, Pain M, Balchandani P, Shrivastava RK: Can MRI predict meningioma consistency?: a correlation with tumor pathology and systematic review. Neurosurg Rev [epub ahead of print], 2016"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/44\/6\/article-pE10.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/44\/6\/article-pE10.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/44\/6\/article-pE10.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T08:23:54Z","timestamp":1780129434000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/44\/6\/article-pE10.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6]]},"references-count":60,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2018.2.focus1849","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6]]}}}