Abstract:
Parasagittal meningiomas (PSM), accounting for up to 40% of intracranial meningiomas, pose significant
neurosurgical challenges due to their anatomical relationship with the superior sagittal sinus (SSS). This study
examines the recurrence risk factors following surgical treatment and therapeutic solutions. The study aims to
analyze the anatomical, histological and clinical factors influencing the recurrence of parasagittal
meningiomas, in order to improve therapeutic and prognostic strategies. Retrospective-analytical study carried
out through comparative analysis of data from the literature. Anatomical, histological, and operative factors
were evaluated, using the WHO 2021 classification, Simpson grade, and parameters such as peritumoral
edema, tumor consistency, and SSS invasion. Statistical tests included χ² and Pearson correlations. Recurrence
was influenced by the grade of resection: recurrence-free rates at 5/10/15 years were 93%/80%/68% for Simpson
grades I-II, and 63%/45%/9% for grades III-IV (p<0.05). Soft tumors, with dural or osseous invasion, recurred
in 56% of cases. Atypical/anaplastic histology and overt cerebral infiltration are associated with a poor
prognosis. Peritumor edema and the cystic components, although frequently encountered, did not have a
consistent predictive value. Multifocality and a low Karnofsky index were associated with an increase in
recurrence, especially in cases with limited resection due to anatomical factors. The extent of resection remains
the main determinant of postoperative outcome in patients with PSM. Histological type, macro-morphological
aspects, and preoperative functional status influence the risk of recurrence. Prospective studies are needed to
validate these factors.
