Hysterosalpingographic Findings Among Ghanaian Women with Infertility: A Five-year Trend Analysis.

Objectives: To understand the pattern of hysterosalpingographic (HSG) findings and annual trends among Ghanaian women with infertility over a five-year period. Methods: We retrospectively evaluated the hospital medical records of women with infertility who underwent HSG at a major tertiary center in Ghana between January 2018 and December 2022. The data was statistically analyzed. Results: The subjects comprised of 2324 Ghanaian women diagnosed with clinical infertility. HSG identified 1685 (72.5%) with primary infertility and they were also younger women with a mean age of 32.2±4.5 years. The remaining 639 (27.5%) women had secondary infertility and were older (34.2±5.3 years; p < 0.001). Primary infertility rate decreased with increasing age (p < 0.001). Bilateral tubal blockage was seen in 701 (41.6%) women with primary infertility and 365 (57.1%) women with secondary infertility. Hydrosalpinx was present in 236 (10.2%) women, fimbrial adhesions in 444 (19.1%), Asherman's syndrome in four (0.2%), and bilateral beaded tubes/tubercular salpingitis in five (0.2%). HSG was unable to detect infertility-related abnormalities in 513 (22.1%) women despite their clinical infertility. The majority of patients (1502; 64.6%) had tubal blockage: bilateral in 1066 (45.9%) and unilateral in 436 (18.8%). Conclusions: Infertility rates among Ghanaian women increased at an accelerating rate over the years. Primary infertility was significantly more prevalent among younger women. Tubal and cervical abnormalities were the most prevalent HSG findings.

Evaluation of the ultrasound findings of thyroid gland enlargement in Cape Coast Teaching Hospital, Ghana: A retrospective cross-sectional study.

Background and Aim: Goiter is a major source of morbidity in the world, especially in the developing world, where dietary iodine deficiency, a known cause of this condition, is endemic. The diagnosis is mostly by ultrasonography (USG) scan, which can give anatomical, pathological, and functional information for the management of goiter. This study aimed to determine the commonest ultrasound findings of goiter in Ghana. Method: The records of all 213 patients with goiter diagnosed by USG scan over a 5-year period were retrieved. Data collected were sociodemographics, ultrasound features, thyroid nodules diameter, and Thyroid Imaging Reporting and Data System (TI-RADS) scores, which were analyzed using GNU PSPP, version 1.2.0-3. χ 2 and two-tailed independent samples t-test were also employed, with p ≤ 0.05. Results: A total of 213 patients with goiter diagnosed by USG scan were obtained over the study period. The mean age of the participants was 50.01 ± 17.27 years, with an age range of 16-92 years and females constituting the majority (82.16%). The commonest ultrasound features were well-defined solid nodules. The lesion sites for most patients were the whole thyroid (28.17%), both lobes (24.41%), and the right lobe (20.19%). The mean difference in sizes of cysts and solid nodules among genders was 0.26 (CI: -0.14 to 0.67, p = 0.20) and 0.12 (CI: -0.43 to 0.66, p = 0.67), respectively. The TI-RADS score featured TI-RADS 4 (36.62%), TI-RADS 1 (28.17%), TI-RADS 3 (25.82%), TI-RADS 5 (5.16%), and TI-RADS 2 (4.23%). Solid nodules (49.32%, p = 0.001) and cysts (35.71%, p = 0.003) were more common within 41-60 years and less frequent in those <21 years. A p ≤ 0.05 was considered significant in this study. Conclusion: The predominant ultrasound features were well-defined solid nodules, simple cysts, and solid nodules with cystic changes, mostly located in the entire thyroid gland and least located in the isthmus only. Cysts and solid nodules were mostly seen in the 41-60 years age group.

Sporadic Class II Congenital humeroradial synostosis and Left Micromelia in a three-and-a-half-months female Ghanaian infant.

Congenital humeroradial synostosis (CHRS) is a rare musculoskeletal condition that significantly affects the mobility of the elbow joint. They occur in various types and forms depending on the types and numbers of bones involved at the elbow. CHRS may present with elbow deformity and limitation of function. Appropriate timely diagnosis and counseling are required since CHRS is mostly managed conservatively according to literature and may prevent avoidable fractures of the radius from attempts by parents to straighten the flexed fixed elbow and finally offer adequate time for delayed surgical intervention which is usually ineffective and unhelpful.

Terson's syndrome leading to fatal outcome in a 36-year-old woman: A case report.

Terson's syndrome occurs as a result of intraocular hemorrhage associated with intracranial hemorrhage, but was formerly used to describe vitreous hemorrhage associated with Aneurysmal Subarachnoid Hemorrhage (SAH). We present a case of a 36-year-old woman who was not a known hypertensive but presented with a sudden onset of loss of vision in both eyes and a few hours later became deeply unconscious. A computed tomography (CT) scan of the head revealed massive intracerebral hemorrhage with intraventricular extension secondary to severe hypertension and bilateral acute retinal hemorrhages due to the acute rise in intracranial pressure and the recently described ocular glymphatic system provides a novel perspective on the pathophysiology. A diagnosis of Terson's syndrome was made but unfortunately, her clinical condition deteriorated and she expired a few hours after the CT scan. Terson's syndrome is usually associated with poor clinical outcomes from increased intracranial pressure. Implication for clinical practice is that radiologists should critically examine the orbits during imaging for retinal hemorrhage in the setting of severe intracranial hemorrhage for the necessary ophthalmological and neurosurgical interventions to be made since most patients present with sudden onset of loss of vision.

Incidental ultrasound finding of cholelithiasis in an 8-week-old infant: A case report.

Infantile cholelithiasis is a rare occurrence. It is often diagnosed incidentally during ultrasonography for other conditions as most cases are asymptomatic and may be self-limiting. A few cases may however present with prolonged neonatal or infantile jaundice. We report our initial experience with an incidental case of infantile cholelithiasis in an 8-week-old male infant who was brought to our ultrasound unit in Accra, Ghana, for an abdominal ultrasound on account of conjugated hyperbilirubinemia and pigmented stools. The patient had presented initially at the children's emergency unit of the Korle-Bu Teaching Hospital, 2 days after an uneventful delivery, with a history of yellowing of the eyes, noticed on the first day of life, which necessitated the request for the ultrasound examination, leading to this rare finding of infantile cholelithiasis. The availability and use of modern sonographic equipment are likely to result in more effective detection of this incidental finding and its subsequent management.

Perspectives of radiologists in Ghana about the emerging role of artificial intelligence in radiology.

Background: The integration of Artificial Intelligence (AI)-based technologies in medicine is advancing rapidly especially in the field of radiology. This however, is at a slow pace in Africa, hence, this study to evaluate the perspectives of Ghanaian radiologists. Methods: Data for this cross-sectional prospective study was collected between September and November 2021 through an online survey and entered into SPSS for analysis. A Mann-Whitney U test assisted in checking for possible gender differences in the mean Likert scale responses on the radiologists' perspectives about AI in radiology. Statistical significance was set at P ≤ 0.05. Results: The study comprised 77 radiologists, with more males (71.4%). 97.4% were aware of the concept of AI, with their initial exposure via conferences (42.9%). The majority of the respondents had average awareness (36.4%) and below average expertise (44.2%) in radiological AI usage. Most of the participants (54.5%) stated, they do not use AI in their practices. The respondents disagreed that AI will ultimately replace radiologists in the near future (average Likert score = 3.49, SD = 1.096) and that AI should be an integral part of the training of radiologists (average Likert score = 1.91, SD = 0.830). Conclusion: Although the radiologists had positive opinions about the capabilities of AI, they exhibited an average awareness of and below average expertise in the usage of AI applications in radiology. They agreed on the potential life changing impact of AI and were of the view that AI will not replace radiologists but serve as a complement. There was inadequate radiological AI infrastructure in Ghana.

Assessment of the Clinical Presentations and Ultrasonographic Features of Uterine Fibroids in Adult Africans: A Retrospective Study.

Objectives: We sought to determine the clinical presentations and ultrasonographic features of uterine fibroids in adult Ghanaians. Methods: Between 1 January 2018 and 31 December 2021, 4279 ultrasound-confirmed cases of uterine fibroids were retrieved. The data obtained, which included age, clinical presentations, and sonographic features were analyzed. A chi-squared test was done to assess for possible associations between the clinical indications, age distribution, and ultrasonographic features of uterine fibroids. Results: The mean age of the patients diagnosed with uterine fibroids was 37.1±11.5 years (range = 16-69 years). Routine checkup (n = 1310, 28.1%), menorrhagia (n = 1104, 23.7%), and lower abdominal mass (n = 801, 17.2%) were the leading clinical indications. Dysmenorrhea, amenorrhea, menorrhagia, and routine checkup were significantly noted in the younger patients (p ≤ 0.001). The majority of the fibroid nodules had smooth regular outline (n = 4125, 96.4%) and were mostly heterogeneous (n = 3282, 76.7%). The echo pattern of the nodules was predominantly hypoechoic (n = 3358, 51.1%) followed by hyperechoic nodules (n = 2554, 38.9%). Degenerative changes accounted for less than one-third of the total fibroid nodules, with the least recorded degenerative change being nodules with cystic areas (n = 55, 5.4%) and the most observed degenerative feature being nodules with rim of calcification and areas of calcified degeneration (n = 965, 94.6%). Almost all the sonographic features were significantly seen in the 30-44 years age category. Conclusions: Sonographically, uterine fibroids were mostly hypoechoic heterogeneous nodules with a smooth regular outline with a predominant occurrence within women in the fourth to fifth decade of life.

Age of first diagnosis and incidence rate of uterine fibroids in Ghana. A retrospective cohort study.

BACKGROUND: Uterine fibroids are benign tumors that grow in or on the uterus of women. Globally, they occur in more than 80% of women of African ancestry and 70% in white women. Uterine fibroid requires much attention because of its high incidence rate among women of all races and ages. This study sought to document the age of first diagnosis and incidence rates of uterine fibroids in our urban setting. METHODS: This study reviewed and analyzed the ages and year of diagnosis of all 2,469 patients with the first diagnosis of uterine fibroids from 1st January 2018 to 31st December 2021 in South-Central Ghana. The obtained data were analyzed using GNU PSPP, Python on Jupyter Notebook and Libre Office Calc with statistical significance level set at p≤0.05. RESULTS: The overall average age was 36.29±8.08 years, with age range 17-61 years and the age groups with the highest frequencies were 35-39 years (n = 642, 26.00%), 30-34 years (n = 563, 22.80%) and 40-44 years (n = 381, 15.43%). The mean ages of the patients in 2018, 2019, 2020 and 2021 were 36.70±8.00 years (95%CI = 35.97-37.43), 37.07±7.66 years (95%CI = 36.45-37.70), 35.92±7.87 years (95%CI = 35.30-36.53) and 35.78±8.54 years (95%CI = 35.19-36.38) respectively. The incidence rate (per 100,000) of uterine fibroids in 2018, 2019, 2020 and 2021 were 66.77 (95% CI = 60.63-72.90), 81.86 (95%CI = 75.19-88.58), 85.60 (95%CI = 78.85-92.35) and 92.40 (95%CI = 85.88-98.92) respectively, with 35-39 age group recording the highest in all years. CONCLUSION: The incidence rate of uterine fibroids increased as the years progressed and it is mostly high in 35-39 years age category, with a decreasing annual mean age trend indicative of early diagnosis.

Patient radiation dose during diagnostic and interventional cardiology procedures: A study in a tertiary hospital.

BACKGROUND: Fluoroscopy-guided diagnostic and interventional cardiology (IC) procedures help to identify and treat several problems associated with the heart. However, these procedures expose patients, cardiologists, radiographers, and nurses to radiation doses. Due to the risk that ionizing radiation poses, concerns have been raised and studies are continually being done to ensure that optimization is achieved during such procedures. This study assessed patient radiation dose during diagnostic and interventional cardiology procedures as well as right heart studies at a tertiary hospital in Ghana to formulate the facility's diagnostic reference levels (DRLs) for optimization purposes. As this study was the first of its kind in Ghana, it was a vital step towards dose optimization within the local department, as well as contributing to future DRLs in Ghana. METHODS: The study collected dose (air kerma, and kerma area product (KAP) and procedural data, and assessed any correlation between parameters such as fluoroscopy time and KAP, and between body mass index (BMI) and KAP. The DRL values were determined as the 75th percentile level for the dose distribution for the various IC procedures including percutaneous coronary interventions (PCI), coronary angiography (CA), and right heart catheterization (RHC). Data were analyzed using SPSS version 23. RESULTS: CA was the most frequently performed IC procedure (77.3%), while RHC was the least recorded (3.3%). The highest mean KAP was observed during the PCI procedure. The proposed diagnostic reference levels (DRLs) were 162.0 Gy.cm2 (PCI), 69.4 Gy.cm2 (CA), 39.8 Gy.cm2 (RHC) and 159.9 Gy.cm2 (CA+PCI). Patients who presented for the CA+PCI and RHC procedures received the highest and lowest mean KAP of 159.9 Gy.cm2 and 39.8 Gy.cm2 of radiation respectively. CONCLUSION: This study, therefore, concludes that there is a need for dose optimization of radiation exposures for IC procedures at the cardiothoracic center in Ghana.

Unilateral congenital proximal radioulnar synostosis in a 4-year-old boy: A case report.

Congenital radioulnar synostosis is a rare musculoskeletal disorder of the elbow, occurring as a result of variable degree and length of the congenital fusion of the proximal radioulnar joint. Patients presents early to the hospital depending on the severity of the synostosis and its effect on elbow function. It may have psychosocial effects on the affected individuals as they grow older especially when the deformity is dramatic. Treatment may be conservative, surgical (which may have a variable degree of success) and psychotherapy.

Intracranial aneurysms in Ghanaian adults

Objective: To document the location, size, and multiplicity of intracranial aneurysms in Ghanaians who have undergone digital subtraction angiography (DSA) at a single centre in Accra, Ghana. Design: We conducted a retrospective observational review of the medical records of all patients diagnosed with intracranial aneurysms on DSA Setting: Patients' medical records at Euracare Advanced Diagnostic and Heart Centre were reviewed between March 2018 and March 2020. Participants: Thirty-one patients were identified with various intracranial aneurysms (IAs) within the study period. Patients' ages, sex, and types of IAs were extracted using a checklist and analysed using Microsoft Excel for Windows 2016. Interventions: None Main outcome measures: The prevalence of types and distribution of intracranial aneurysms. Results: The age range of the patients was 26-76 years, with a mean age of 45.5±14.3 years. The mean age of men and women with IA was 45.5 ±15.9 years and 46.7 51.3±12.9 years, respectively. The most common IAs were located in the posterior communicating artery (PCOM) at 54.8% (95%CI: 36.0, 72.7), followed by the anterior communicating (ACOM), which constituted 32.3% (95%CI: 16.7, 51.4). The majority, 89.2% (33/37) of these aneurysms were less than 7mm in diameter. Single aneurysms were present in 25 (80.6%). Conclusion: The most common IAs were found in the PCOM and ACOM, and IAs tend to rupture at a younger age and smaller size among the Ghanaian adults examined. Early detection and treatment of IAs less than 7mm in diameter is recommended.

Evaluation of the anatomical locations and sizes of uterine fibroids from ultrasound examination in Ghana.

Background: Uterine fibroids locations and sizes, have significant influences on the quality of life of women especially pregnant women and on live birth rate. Objectives: To determine the anatomical locations and sizes of uterine fibroids and assess any possible associations with age groups. Methods: This retrospective study reviewed the locations and sizes of a total of 3,542 patients who were ultrasonographically diagnosed with uterine fibroids from January 2019 to December 2021. The obtained data were analysed using GNU PSPP, and Python on Jupyter Notebook with statistical significance level set at p≤0.05. Results: The overall average diameter of uterine myoma was 5.50±2.60cm (95%CI=5.41-5.58, range=1.00cm-19.10cm) and the respective mean diameter of intramural, subserosal and submucosal fibroids were 5.53±2.60cm (95%CI=5.44-5.62), 5.50±2.27cm (95%CI=5.27-5.74) and 5.82±2.77cm (95%CI=5.49-6.14). Most of the fibroid nodules were small (48.36%, n=1713) and only 5.84% (n=207) were large (>10cm). Posterofundal fibroids and lower anterior myomas were mostly seen in the 35-44 years age class. Conclusion: The majority of the uterine fibroids were intramural and were mostly at the anterior uterine wall. The submucosal fibroids, even though the rarest, were averagely larger than the other types of uterine myomas. The diameter of uterine fibroids increased with age.

Intracranial aneurysms in Ghanaian adults.

Objective: To document the location, size, and multiplicity of intracranial aneurysms in Ghanaians who have undergone digital subtraction angiography (DSA) at a single centre in Accra, Ghana. Design: We conducted a retrospective observational review of the medical records of all patients diagnosed with intracranial aneurysms on DSA. Setting: Patients' medical records at Euracare Advanced Diagnostic and Heart Centre were reviewed between March 2018 and March 2020. Participants: Thirty-one patients were identified with various intracranial aneurysms (IAs) within the study period. Patients' ages, sex, and types of IAs were extracted using a checklist and analysed using Microsoft Excel for Windows 2016. Interventions: None. Main outcome measures: The prevalence of types and distribution of intracranial aneurysms. Results: The age range of the patients was 26-76 years, with a mean age of 45.5±14.3 years. The mean age of men and women with IA was 45.5 ±15.9 years and 46.7 51.3±12.9 years, respectively. The most common IAs were located in the posterior communicating artery (PCOM) at 54.8% (95%CI: 36.0, 72.7), followed by the anterior communicating (ACOM), which constituted 32.3% (95%CI: 16.7, 51.4). The majority, 89.2% (33/37) of these aneurysms were less than 7mm in diameter. Single aneurysms were present in 25 (80.6%). Conclusion: The most common IAs were found in the PCOM and ACOM, and IAs tend to rupture at a younger age and smaller size among the Ghanaian adults examined. Early detection and treatment of IAs less than 7mm in diameter is recommended. Funding: None declared.

Pattern of chest computerized tomography scan findings in symptomatic RT-PCR positive Covid-19 patients at the Korle Bu Teaching Hospital, Ghana.

Background: Chest Computerized Tomography (CT) features of Corona Virus Disease 2019 (COVID-19) pneumonia are nonspecific, variable and sensitive in detecting early lung disease. Hence its usefulness in triaging in resource-limited regions. Objectives: To assess the pattern of chest CT scan findings of symptomatic COVID-19 patients confirmed by a positive RT-PCR in Ghana. Methods: This study retrospectively reviewed chest CT images of 145 symptomatic RT-PCR positive COVID-19 patients examined at the Radiology Department of the Korle Bu Teaching Hospital (KBTH) from 8th April to 30th November 2020. Chi-Squared test was used to determine associations among variables. Statistical significance was specified at p≤0.05. Results: Males represent 73(50.3%). The mean age was 54.15±18.09 years. The age range was 5 months-90 years. Consolidation 88(60.7%), ground glass opacities (GGO) 78(53.8%) and crazy paving 43(29.7%) were the most predominant features. These features were most frequent in the elderly (≥65years). Posterobasal, peripheral and multilobe disease were found bilaterally. The most common comorbidities were hypertension 72(49.7%) and diabetes mellitus 42(29.2%) which had significant association with lobar involvement above 50%. Conclusion: The most predominant Chest CT scan features of COVID-19 pneumonia were GGO, consolidation with air bronchograms, crazy paving, and bilateral multilobe lung disease in peripheral and posterior basal distribution.

Contrast Medium Use in Computed Tomography for Patients Presenting with Headache: 4-year Retrospective Two-Center Study in Central and Western Regions of Ghana.

Background: Contrast medium (CM) administration during computed tomography (CT) enhances the accuracy in the detection and interpretation of abnormalities. Evidence from literature also validate the essence of CM in imaging studies. CT, by virtue of its ubiquity, ease of use, speed, and lower financial footprint, is usually the first investigation in cases of headache. Through a multicenter retrospective analysis, we compared findings of contrast-enhanced CT (CECT) to noncontrast-enhanced CT (NCECT) head examinations among patients presenting with headache. Methods: A multicenter retrospective analysis of four years' CT head examination data at two radiology centers located in Central and Western Regions of Ghana were reviewed. Records of patients who presented with headache as principal complaint between January 2017 and December 2020 were reviewed. A total of 477 records of patients with headache were identified, retrieved and evaluated. A Chi-square test and Fisher exact test were used to compare the CECT and NCECT groups. Binary logistic regression analysis was computed to assess association between CECT and each CT findings. Statistical significance was considered at p < 0.05 with a 95% confidence interval. Results: A significant proportion of the patients was females (51.8% in CECT and 60% in NCECT). The NCECT group (40.06 ± 14.76 years) was relatively older than the CECT group (38.43 ± 17.64 years). There was a significant difference between the CECT and NCECT in terms of age (p=0.002) and facility CT was performed (p < 0.0001). The rate of abnormalities was higher in CECT (43.5%, 166/382) compared NCECT (37.9%, 36/95). There was no significant association between CT head findings and contrast enhancement. Conclusion: CECT examination accounted for 5.6% increase in the detection of head abnormalities. Efforts required to establish local standard operation procedures (SOPs) for contrast medium use especially in CT head examinations. Further studies to improve the knowledge of agents, mechanism of action, and safety of contrast media used among practitioners in Ghana is recommended.

Unintentionally retained pelvic drainage tube found on Imaging; A case report.

A retained drainage tube after surgery is rare and patients may be asymptomatic if it occurs. The presence of a retained drainage tube may be first recognized on imaging and this requires a high index of suspicion by radiologists. In this case report, we described an incidental finding of an asymptomatic retained fractured drainage tube in the pelvis of a 32-year-old female on ultrasonography for renal evaluation. This highlighted the need for radiologists to have a high index of suspicion when performing ultrasonography on postoperative patients and surgeons should be meticulous when removing drainage tubes postsurgery. The possibility of a foreign body should be considered when unfamiliar findings are encountered on imaging. Surgeons should inspect drainage tubes after removal to ensure the full length of the tube is removed.

Computed tomography patterns of intracranial infarcts in a Ghanaian tertiary facility.

Objective: To determine the Computed Tomography (CT) patterns of intracranial infarcts. Design: A retrospective cross-sectional study. Setting: The CT scan unit of the Radiology Department, Cape Coast Teaching Hospital (CCTH), from February 2017 to February 2021. Participants: One thousand, one hundred and twenty-five patients with non-contrast head CT scan diagnosis of ischaemic strokes, consecutively selected over the study period without any exclusions. Main outcome measures: Patterns of non-contrast head CT scan of ischaemic strokes. Results: About 50.6% of the study participants were females with an average age of 62.59±13.91 years. Males were affected with ischaemic strokes earlier than females (p<0.001). The risk factors considered were, hyperlipidaemia (59.5%), hypertension (49.0%), Type 2 diabetes mellitus (DM-2) (39.6%) and smoking (3.0%). The three commonest ischaemic stroke CT scan features were wedge-shaped hypodensity extending to the edge of the brain (62.8%), sulcal flattening/effacement (57.6%) and loss of grey-white matter differentiation (51.0%), which were all significantly associated with hypertension. Small deep brain hypodensities, the rarest feature (2.2%), had no significant association with any of the risk factors considered in the study. Conclusion: Apart from the loss of grey-white matter differentiation, there was no significant association between the other CT scan features and sex. Generally, most of the risk factors and the CT scan features were significantly associated with increasing age. Funding: None declared.

Transient cortical blindness, a rare complication during cerebral digital subtraction angiography: A case report and literature review.

Transient cortical blindness (TCB) is a rare consequence of cerebral angiography with no recognized cause. TCB was observed in a patient with a wide-neck cavernous aneurysm during digital subtraction angiography. One hour after angiography, vision returned spontaneously, with no neurological damage. An MRI was performed three hours after the incident and revealed no abnormalities.

Challenges of practicing neuro-endovascular interventions in a resource-limited country; Ghana in focus.

OBJECTIVE: Now is the time to reflect on the situation of neuro-endovascular interventions (NEVT) in Africa, particularly Ghana, and to renew our commitment to provide high-quality health care to our people. This evaluation is significant because it seeks to assess progress toward our goals and identify potential obstacles for remedial action and to highlight the challenges of NEVT in Ghana. METHODS: Retrospective review of all endovascular treatments performed between January 1, 2019, and December 31, 2021, at two Ghanaian hospitals. A descriptive analysis was done having entered data in Microsoft Excel utilizing frequencies and percentages. Four experienced specialist radiologists discussed NEVT issues in Ghana. The fishbone diagram was used to depict the challenges and problems of NEVT practices in Ghana. RESULTS: From January 2019 to December 2021, 278 patients' records were analyzed at two Ghanaian hospitals. The majority of patients (71.9%) had digital subtraction angiography of the head and neck. The high cost of medical supplies, lack of vendor interest, and limited awareness of symptoms by general practitioners were noted as obstacles associated with neuro-endovascular treatment in Ghana. CONCLUSION: Although the future of NEVT is bright, Interventional Neuroradiologists and other stakeholder need to make conscious effort to improve quality, accessibility, and cost of NEVT in Ghana.