ABSTRACT
Abstract: Neuronal migration disorders (NMDs) are congenital brain malformations caused by disrupted neuronal development and often lead to epilepsy and other neurological deficits. These conditions are rare, occurring in approximately one in every 2,500 live births. Early detection through prenatal and neonatal imaging is crucial for prompt genetic counselling, testing, and neurosurgical intervention. In Ghana, limited access to advanced medical imaging services such as magnetic resonance imaging (MRI) and computed tomography complicates the diagnosis of NMD. This medical imaging case report describes a 39-year-old Ghanaian woman with a 24-year history of epilepsy. Although the patient had a CT scan 15 years before the current hospital visit, a definitive diagnosis was not achieved until now through MRI. The MRI findings revealed a hypoplastic cerebellum, heterotopia, lissencephaly, expansion of the fourth ventricle, and a dilated cisterna magna, in keeping with NMD. The discussion focuses on the diagnostic capabilities of ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) in identifying congenital brain malformations. It emphasises their respective advantages and limitations, while also highlighting the urgent need to enhance neuroimaging accessibility and to develop specialised radiological training programs in Ghana. The case underscores the paramount importance of MRI in accurately delineating cerebral anatomy and offers valuable insights into the detection and management of neuronal migration disorders.

ABSTRACT
Background: Sacrococcygeal teratoma (SCT) is the most common congenital tumor in infants, with early diagnosis and accurate preoperative characterization being crucial for optimal management. Imaging modalities, particularly X-ray and ultrasonography (USG), play a key role in identifying tumor features and guiding surgical planning. This study aimed to correlate imaging findings with histopathological outcomes in infants and toddlers with SCT. Methods: This cross-sectional observational study was conducted at the Department of Radiology and Imaging, Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh, from December 2020 to March 2025. A total of 40 infants and toddlers with SCT who underwent surgical excision were included consecutively. X-ray and USG evaluations were performed preoperatively, assessing features such as soft tissue mass, calcifications, cystic and solid components, mixed echogenicity and vascularity. Histopathology was considered the gold standard, classifying tumors as mature or immature. Imaging findings were correlated with histopathological diagnosis. Results: Among the 40 patients, 55% were aged 6–12 months and 65% were female. Histopathology revealed 38 (95%) mature and 2 (5%) immature teratomas. X-ray showed a soft tissue mass in 75% of cases, calcifications in 30% and bony involvement in 10%. USG demonstrated cystic components in 70%, solid components in 40%, mixed echogenicity in 35%, calcifications in 25% and vascularity in 15%. Imaging correctly identified 38 mature tumors as benign, while 2 were immature tumors. Conclusion: Conventional X-ray and USG demonstrate high concordance with histopathology and effectively identify mature SCTs, while highlighting features suggestive of immaturity. These modalities remain valuable tools for preoperative assessment, especially in resource-limited settings.