Treatment of pseudoaneurysms by the injection of thrombin have been reported in the literature with a success rate approaching 100%. Complications have been reported with its use. We report a case where thrombin was used to thrombose a superficial temporal artery pseudoaneurysm leading to the development of seizure and ischaemia of the scalp. We advise that thrombin should be not be used to thrombose pseudoaneurysms of arteries supplying critical areas.

Ketotifen (benzocycloheptathiophene) was evaluated in a double‐blind study of patients with active rheumatoid arthritis. Sixty patients were randomly allocated to receive active or matching placebo drug and reviewed 6 weekly for 24 weeks. Conventional NSAIDs were continued throughout. Disease activity was assessed clinically and biochemically at weeks 0, 12 and 24. Nineteen patients remained on active drug for 24 weeks and 11 on placebo. Significant improvement in articular index was seen in both groups but no objective improvement was noted in either group. No undue toxicity was encountered in either group. Use of a drug considered to have selective LTC4 and LTD4 antagonism in combination with conventional cyclo‐oxygenase inhibitors did not confer any additional benefit in rheumatoid arthritis.

Obstruction of the inferior or superior vena cava normally leads to the formation of a well-described and consistent pattern of collateral venous pathways. We present the angiographic and CT features of the unusual development of systemic to portal venous shunting in two cases with central vein obstruction.