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A 59-year-old man presenting with an acute stroke caused by intracranial large-vessel occlusion, found to have an incidentally discovered metastatic mediastinal adenopathy (arrows, first image) and a pathologic fracture of the C7 vertebral body (arrow, second image) on computed tomography angiogram of the head and neck. Both findings were new and unknown to the patient and clinical team at the time of the scan.
