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A 48-year-old woman with severe juvenile-onset rheumatoid arthritis presented with a bleeding cutaneous sinus distal to her right total hip replacement scar. Methicillin resistant Staphylococcus aureus (MRSA) was isolated on culture. She had previously undergone bilateral total hip and knee replacements at aged 23 and six years later had the right knee prosthesis removed for infection, with subsequent osteomyelitis of the femoral shaft and right total hip prosthesis disruption. Peripheral arteriography was performed in view of persistent bleeding from the sinus, which revealed a 6 cm false aneurysm filling from and compressing the right external iliac artery (EIA). A PTFE-covered, balloon expandable JOSTENT was deployed in the right EIA, successfully excluding the false aneurysm and preventing further bleeding from the sinus. No graft infection was reported at 12 months. This case illustrates the potential use of endovascular stent-grafting in the treatment of an infected pseudoaneurysm.

Chlorpromazine, given intravenously, is a useful agent in the treatment of acute migraine headaches. Patients with more serious conditions, however, may also respond to this medication. In this paper we report two patients who were initially diagnosed as having migraine headaches and treated with chlorpromazine. Both experienced temporary pain relief and it was only after repeated presentations to the emergency department that their conditions--a subarachnoid hemorrhage and a subdural hematoma--were accurately diagnosed. Because of this, caution must be exercised before re-treating within a short period of time, a patient with recurrent headache. Strong consideration must be given to an alternate diagnosis and such a diagnosis should be actively sought should there be any suspicion of a non-migrainous cause for headache. It is only by doing so that we may avoid missing more serious and life-threatening conditions such as those with which our patients presented.

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