Objectives: The radiographic assessment of the head is a crucial part of headache care. A computed tomography (CT) scan enables a more detailed analysis of the condition and more focused care. This study examined head CT scans to determine what kinds of anomalies were present in patients with headaches as their primary complaint. Methods: We evaluated 4 years\' worth of CT scan data from head exams conducted at two diagnostic facilities in Ghana\'s western and central regions. We examined data on 477 patients with a headache as their primary complaint between January 2017 and December 2020. We employed chi-square and Fisher\'s exact tests (where applicable) to compare head CT diagnoses between age groups, gender, headache subtypes, and brain lesion subgroups. Results: There were 53.5% (n = 255) females and 46.5% (n = 222) males in the study. The average age of patients was 38.67 ± 17.23 years, with an annual rate of abnormal CT diagnoses ranging from 35.9% in 2017 to 45.4% in 2022. Abnormal head CT diagnoses are strongly correlated with age groups and patient gender (p = 0.011 and p = 0.009, respectively). Of the 202 patients, 15.3% and 24.3% were classified as intracranial lesions and extracranial lesions, respectively. Maxillary sinusitis affected nearly 60% of the patients, while tumors and hemorrhages affected 25.2% and 11.9%, respectively. Conclusions: A CT scan of the head is essential to detect abnormalities in nearly 50% of patients suffering from various degrees of headache. Sinusitis, brain tumors, and hemorrhage were common lesions detected. It is crucial to create local standard operating procedures to promote better utilization of this type of imaging service, particularly among patients who have been diagnosed with headaches.

Hypothermic cardiac arrest (HCA) with concomitant trauma presents a significant clinical management challenge. In these case reports, computed tomography (CT) imaging was performed before extracorporeal cardiopulmonary resuscitation (ECPR) in patients with cardiac arrest, accidental hypothermia, and trauma. The first case involved a 74-year-old male who collapsed outside his home under freezing conditions. Upon arrival at the emergency department (ED), he was in cardiac arrest with a core body temperature of 25.0°C and suspected head trauma. CT imaging revealed minor traumatic brain injuries and bilateral femoral fractures. ECPR was initiated after CT imaging, which led to successful rewarming and full neurological recovery. The second case describes a 32-year-old female who jumped from a bridge, experienced cardiac arrest during the rescue, and had a core temperature of 17.4°C. CT imaging before ECPR revealed no significant trauma. Despite prolonged resuscitation, the patient showed a complete neurological recovery. CT imaging before ECPR allows appropriate patient selection by ruling out cardiac arrest before hypothermia and major hemorrhagic complications. Hypothermic cardiac arrest may be acceptable for prolonged resuscitation time on CT imaging owing to reduced cerebral metabolism. These rare case reports demonstrate the potential benefits of CT imaging before ECPR in the management of hypothermic cardiac arrest with trauma and aid in appropriate candidate selection and effective intervention without compromising neurological outcomes.

Ganglioneuromas are rare tumors arising from retroperitoneal and posterior mediastinal sympathetic nerves. Intracranial trigeminal nerve ganglioneuromas are even more rare, with only seven cases reported to date. We present a case of a 65-year-old male with a right-sided throbbing headache type and blindness in his right eye. Magnetic resonance imaging revealed an ill-defined mass lesion in the middle-cranial fossa, with a few areas having a reduced apparent diffusion coefficient and multiple microhemorrhages. Piecemeal debulking of the tumor was achieved by performing a right-middle craniotomy via the pterionic and sub-temporal approach. The detected histological features matched those of a ganglioneuroma (maturing type) of the trigeminal nerve.

OBJECTIVE: This study aimed to establish a multimodal deep-learning network model to enhance the diagnosis of benign and malignant pulmonary ground glass nodules [GGNs].
METHODS: Retrospective data on pulmonary GGNs were collected from multiple centers across China, including North, Northeast, Northwest, South, and Southwest China. The data were divided into a training set and a validation set in an 8:2 ratio. In addition, a GGN dataset was also obtained from our hospital database and used as the test set. All patients underwent chest computed tomography [CT], and the final diagnosis of the nodules was based on postoperative pathological reports. The Residual Network [ResNet] was used to extract imaging data, the Word2Vec method for semantic information extraction, and the Self Attention method for combining imaging features and patient data to construct a multimodal classification model. Then, the diagnostic efficiency of the proposed multimodal model was compared with that of existing ResNet and VGG models and radiologists.
RESULTS: The multicenter dataset comprised 1020 GGNs, including 265 benign and 755 malignant nodules, and the test dataset comprised 204 GGNs, with 67 benign and 137 malignant nodules. In the validation set, the proposed multimodal model achieved an accuracy of 90.2%, a sensitivity of 96.6%, and a specificity of 75.0%, which surpassed that of the VGG [73.1%, 76.7%, and 66.5%] and ResNet [78.0%, 83.3%, and 65.8%] models in diagnosing benign and malignant nodules. In the test set, the multimodal model accurately diagnosed 125 [91.18%] malignant nodules, outperforming radiologists [80.37% accuracy]. Moreover, the multimodal model correctly identified 54 [accuracy, 80.70%] benign nodules, compared to radiologists\' accuracy of 85.47%. The consistency test comparing radiologists\' diagnostic results with the multimodal model\'s results in relation to postoperative pathology showed strong agreement, with the multimodal model demonstrating closer alignment with gold standard pathological findings [Kappa=0.720, P<0.01].
CONCLUSIONS: The multimodal deep learning network model exhibited promising diagnostic effectiveness in distinguishing benign and malignant GGNs and, therefore, holds potential as a reference tool to assist radiologists in improving the diagnostic accuracy of GGNs, potentially enhancing their work efficiency in clinical settings.

Patulous Eustachian tube is a physical disorder in which the normally closed Eustachian tube remains open intermittently. Internal carotid artery (ICA) anomalies accompanied by Eustachian tube anomalies have been described very rarely in the literature. To the best of our knowledge, the presented case is the second case in the literature. In this report, we present a rare case of ICA anomalies accompanied by a bilateral patulous Eustachian tube in a 51-year-old woman.

OBJECTIVE: The purpose of this study was to investigate whether the vastus medialis oblique (VMO) muscle compensates in patellar dislocation (PD) patients with the increased femoral anteversion angle (FAA).
METHODS: Between 2021 and 2024, we included 60 patients with recurrent PD (RPD group). Inclusion criteria were at least two episodes of PD, as well as complete CT scans of the knee and hip. Exclusion criteria included traumatic or habitual dislocation, previous knee surgery, etc. Of these patients, 30 with excessive FAA (≥ 30°) were assigned to the A group, and 30 without excessive FAA (< 30°) to the B group. A control group of 120 patients without patellofemoral disorders was also included (C group). The cross-sectional areas of the VMO and vastus lateralis muscle (VLM) were measured 20 mm above the patella on CT scans, and the VMO/VLM area ratio was calculated. The correlation between FAA and the VMO/VLM ratio was analyzed.
RESULTS: The RPD group had a significantly larger FAA (15.0 ± 1.9° vs. 30.1 ± 9.6°, P = 0.040) and a smaller VMO/VLM ratio (4.2 ± 1.5 vs. 3.5 ± 1.0, P = 0.014) compared to the C group. Within the RPD group, the A group had a higher VMO/VLM ratio than the B group (4.0 ± 1.1 vs. 3.0 ± 0.7, P = 0.029). The B group\'s VMO/VLM ratio was lower than that of the C group (3.0 ± 0.7 vs. 4.2 ± 1.5, P = 0.004). However, there was no significant difference in the VMO/VLM ratio between the A group and the C group. The VMO/VLM ratio showed a moderate positive correlation with FAA in the RPD group, with a correlation coefficient of r = 0.4 (P = 0.012), indicating a statistically significant relationship between the two.
CONCLUSIONS: Patients with recurrent PD showed a smaller VMO/VLM ratio compared to controls. Increased FAA was correlated with compensatory thickening of the VMO and a higher VMO/VLM ratio in PD patients. This suggests that increased FAA may drive biomechanical adaptations in the quadriceps, stabilizing the patella. Clinicians should consider changes in FAA when assessing and treating PD.
METHODS: Level III.

OBJECTIVE: To evaluate clinical and radiological features of extraskeletal myxoid chondrosarcomas (EMC).
METHODS: Our pathology database was queried for cases of EMCs. Tumor location, size, imaging appearance, presence of metastases, disease recurrence, and clinical outcome were documented. Imaging studies were evaluated in consensus by a musculoskeletal radiologist and an orthopedic oncologist.
RESULTS: Thirty subjects met the inclusion criteria (mean age 52.7 ± 16.2 years; 19 male, 11 female), 17 (56.7%) of which had pre-operative imaging. Tumors occurred most often in the lower extremities (20/30; 66.7%). All cases presented as a soft-tissue mass without mineralization on XR or CT. On MRI, tumors were typically hyperintense on T2-weighted sequences (14/14; 100%) and had a chondroid matrix appearance (12/14; 85.7%). Tumor invasion was observed in 11 out of 16 (68.9%) patients and necrosis in 2 out of 11 subjects (18.2%). All subjects had their tumors examined by pathology, and 20 (66.7%) subjects also had descriptive information in addition to the diagnosis (tumor invasion, mitotic rate, and necrosis) noted in the pathology reports. The mean duration of follow-up was 9.4 ± 7.5 (1.0 - 29.6) years. At the last follow-up, 14 out of 28 (50%) subjects were disease-free, 6 out of 28 had persistent metastatic disease and 8 out of 28 had died.
CONCLUSIONS: EMC is a rare sarcoma that commonly presents as lower extremity soft tissue mass with chondroid appearance on MRI. Unlike conventional chondrosarcomas, EMC do not demonstrate mineralization on XR or CT.