Common carotid to vertebral artery bypass to facilitate endovascular treatment of a basilar artery aneurysm.

Large posterior circulation intracranial aneurysms have a high risk of significant morbidity or mortality if left unmanaged. Endovascular techniques are well established as primary treatment for such aneurysms. This includes placement of endovascular flow diversion stents that result in progressive thrombosis and resolution of aneurysms. Successful stent placement is reliant on suitable cervical vascular access. We report a case of a 60-year-old male without direct vertebral artery access to a fusiform basilar artery aneurysm. Successful endovascular treatment required a novel hybrid technique utilizing a right common carotid to V3 segment vertebral arterial bypass to gain endovascular access to the aneurysm.

Common Carotid Artery Occlusion Presenting with Recurrent Syncopal Episodes.

Symptomatic common carotid artery (CCA) occlusion is an uncommon occurrence that may require surgical intervention. We aim to describe a case of CCA occlusion that presented with the unusual symptom of recurrent syncope. A 69-year-old lady presented with a history of recurrent syncopal episodes and amaurosis fugax associated with left leg weakness. She was found to have a right CCA occlusion on duplex ultrasound and angiography. She underwent a right common carotid endarterectomy and intraoperative findings revealed a heavily calcified plaque in the CCA just proximal to the bifurcation with organised thrombus filling the CCA proximally. CCA occlusion can rarely present with recurrent syncopal episodes. Surgery may be curative.

Skull destruction from intracranial metastasis arising from pulmonary squamous cell carcinoma: a case report.

INTRODUCTION: Squamous cell carcinoma of the lung represents 30% of all non-small cell lung carcinomas. It arises from dysplasia of squamous epithelium of the bronchi and is strongly associated with cigarette smoking. Squamous cell carcinoma of the lung is known to produce metastases in the brain parenchyma. CASE PRESENTATION: We present the case of an 80-year-old indigenous Australian man with an unusual presentation of metastatic carcinoma of the lung. The case demonstrated a squamous cell carcinoma of the lung with an intracranial metastatic lesion destroying the parietal bone and extending into the extracranial soft tissue. A visible deformity as a result of the metastasis was evident on physical examination and computed tomography demonstrated extensive bone destruction. CONCLUSION: The authors were unable to find a case of this occurring from a squamous cell carcinoma of the lung anywhere in the world literature. The case report demonstrates an unusual disease presentation with a rare intracranial metastasis invading through the skull.