Schwannomas are benign tumors, which arise from the Schwann cells of the central or peripheral nerves. They form 8% of all intracranial tumors and most of the cases arise from vestibular division of the 8 th cranial nerve. Rare cases are shown to arise from the olfactory or optic nerve, being devoid of myelin sheath. Up to date and according to our best of knowledge, 66 cases have been reported till now. Here we present a review of the literature and a case report of a 56-year-old male with an accidently discovered anterior cranial fossa schwannoma, following a road traffic accident. Tumor was completely excised, using a right frontal approach. Histopathology revealed Antoni-A cellular pattern. Although rare, but olfactory nerve schwannomas should be included in the differential diagnosis in anterior cranial fossa space occupying lesions, and the approach should be designed taking into consideration, this rare entity.

Background: Transpedicular screws are extensively utilized in lumbar spine surgery. The placement of these screws is typically guided by anatomical landmarks and intraoperative fluoroscopy. Here, we utilized 2-week postoperative computed tomography (CT) studies to confirm the accuracy/inaccuracy of lumbar pedicle screw placement in 145 patients and correlated these findings with clinical outcomes. Methods: Over 6 months, we prospectively evaluated the location of 612 pedicle screws placed in 145 patients undergoing instrumented lumbar fusions addressing diverse pathology with instability. Routine anteroposterior and lateral plain radiographs were obtained 48 h after the surgery, while CT scans were obtained at 2 postoperative weeks (i.e., ideally these should have been performed intraoperatively or within 24–48 h of surgery). Results: Of the 612 screws, minor misplacement of screws (≤2 mm) was seen in 104 patients, moderate misplacement in 34 patients (2–4 mm), and severe misplacement in 7 patients (>4 mm). Notably, all the latter 7 (4.8% of the 145) patients required repeated operative intervention. Conclusion: Transpedicular screw insertion in the lumbar spine carries the risks of pedicle medial/lateral violation that is best confirmed on CT rather than X-rays/fluoroscopy alone. Here, we additional found 7 patients (4.8%) who with severe medial/lateral pedicle breach who warranting repeated operative intervention. In the future, CT studies should be performed intraoperatively or within 24–48 h of surgery to confirm the location of pedicle screws and rule in our out medial or lateral pedicle breaches.

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Glioblastoma multiforme (GBM) is one of the most malignant CNS tumors. Despite advances in treatment modalities, it remains largely incurable. Several studies show that there is a promising survival advantage in treatment of GBM with extended temozolamide as compared to standard adjuvant six cycles. The aim is to evaluate the impact of extended 12 versus standard6 cycles of adjuvant temozolamide (TMZ) on overall survival and progression free survival in glioblastoma multiform patients. Patients and methods:The study was conducted on 40 newly diagnosed cases of glioblastoma referred to Zagazig University Hospital's Clinical Oncology and Nuclear Medicine Department, between January2018and January 2020.Eligible patients are adults between the age of18-65 years. They had normal liver and renal function tests, hemoglobin more than 10gm/dl and Karnofsky Performance Score (KPS) more than70. Patients with recurrent GBM or other active cancer or poor KPS were excluded.The patients were divided into 2 groups: group A included 20 patients treated by radiotherapy at a dose 60Gy/30fraction concurrently with TMZ for 6cycles (conventional TMZ) compared with group B which included 20 patients treated by the same concurrent chemo-radiotherapy regimen followed by 12 cycles of adjuvant TMZ (extended TMZ). RESULTS:The median progression free survival (PFS) was7.3 months and 5.6 months in extended TMZ and conventional TMZ respectively. Median overall survival (OS) was 12.4 months versus 10.8 in extended TMZ and conventional TMZ respectively. Conclusions: the study found that extended TMZ is well tolerated and is associated with increased PFS and OS in treatment of GBM, although being statically not significant. Further studies are needed to evaluate the extended treatment protocol.