Table 5.

Review of literature

Series	Sample size	Observations and implications
1. Mehta et al.[1]	18	Male preponderance
		Relatively higher intraventricular tumors, frequent cystic changes, most common mode of presentation being raised intracranial pressure with systemic features such as headache and vomiting, in pediatric meningioma patients compared to adults.
		Total surgical resection should always be the aim.
		Atypical and aggressive histopathological patterns are more frequently discerned in pediatric patients.
		Patients with complete excision of benign tumors have good prognosis as in adults.
2. Baumgartner and Sorenson[7]	14	Similar observations to Bhagwati et al.
		They reported that pediatric meningiomas tend to be more aggressive compared to their adult counterparts.
		Recurrence rate of pediatric meningiomas is higher.
		In addition, they identified neurofibromatosis and radiation as significant predisposing factors.
		Treatment protocol of children with neurofibromatosis and meningiomas and those with subtotal resection has no unequivocal single answer
3. Thuijs et al.[4]	72	Approximately 25% of pediatric meningiomas show aggressive behavior, which calls for adjuvant therapy.
		5-year survival rate is 83.9%
4. Santos et al.[9]	15	Male predominance
		Presence of radiation, neurofibromatosis, location, and extent of resection are more relevant prognosticating measures than the histopathological grade.
5. Burkhardt et al.[13]	12	Skull base meningiomas, albeit being smaller were difficult to resect completely and subsequently had worse prognosis.
6. Menon et al.[2]	38	Skull base meningiomas and tumors with atypical histopathology are more frequently encountered in the pediatric population. Positive prognosticating factors were identified as younger age (<10 years), superficial location, complete resection, and absence of predisposing conditions such as neurofibromatosis. They moved to make a stronger conclusion, namely that the extent of excision has higher positive predictive value for good outcome than even the histopathological grade.
7. Dash et al.[11]	6	Dedicated to intraventricular pediatric meningiomas; this series elaborated upon the parieto-occipital transcortical, transcallosal approach, and the middle/inferior temporal gyrus approach for such tumors.
8. Ghim et al.[3]	15	This is a unique study concentrating on pediatric meningiomas after radiation. They proposed that such tumors are mainly calvarial in nature, mostly benign and often give themselves in to complete resection.
9. Maranhão-Filho et al.[10]	7	Most of pediatric meningiomas are low grade and have a good prognosis. They had zero mortality. Headaches, seizures, and motor deficits were the most common presenting complaints.
10. Wang et al.[8]	10	Based in China, Wang et al. studied 10 patients of spinal meningiomas. They concluded that spinal meningiomas in pediatric population, especially those associated with neurofibromatosis have worse prognosis.
11. Hanel et al.[15]	2	Pediatric meningioma is an infrequent but relevant differential for any expansive intracranial lesion.
12. Alexiou et al.[16]	8	Reviewed over 16 years, Alexiou et al. concluded that gross total resection best determines the final outcome.
13. Sheikh et al.[17]	9	The meningothelial variant of meningioma was reported to be the most common. Tendency for rapid growth and expansion, malignant transformation, and greater rate of recurrence were cited as reasons for poor prognosis in children as compared to adults.
14. Arivazhagan et al.[18]	33	They concluded similarly in terms of male predominance and worse prognosis when associated with neurofibromatosis. They opined that atypical location makes surgical management challenging.
15. Gao et al.[19]	54	A large series from China, they concluded in a concurrent manner to the above mentioned studies.
16. Erdinçler et al.[20]	29	They recorded that absence of dural attachment is more frequently seen in this age group. Association with neurofibromatosis was upheld to be the most important factor influencing outcome.
17. Ravindranath et al.[14]	31	Sharing similar demographic profile as ours; this study documented use of radiotherapy as a good adjuvant. They also studied their recurrence rate and reported that resurgery and radiotherapy in such cases often portends good outcome.