Predictive scores are used daily in neurosurgery; whether in the context of vertebral metastases requiring surgical stabilization, unruptured cerebral aneurysms or simply to estimate the short and long-mortality in patients with multiple comorbidities. Neurosurgeons constantly refer to predictive tools that allow them to support their clinical judgement and reasoning and lead to coherent patient management.

Once the diagnosis is established, the neurosurgeon (and the multidisciplinary team) managing the patient has to define a reasonable, safe and effective treatment. In order to make a definitive and reliable prognosis according to a specific management, clinical predictors must be applied.

To illustrate the point, intra-cranial meningiomas are used as a paradigm, showing with concrete data and examples how clinical predictors can play a determining role in the daily neurosurgical activity, anticipating as much as possible events such as recurrence, malignant transformation, the occurrence of postoperative complications or the probability of gross total resection, among other specific outcomes.