Dilated Epidural Venous Plexus Causing Radiculopathy: A Report of 2 Cases and Review of the Literature

Hallan, David R; McNutt, Sarah; Reiter, G. Timothy; Thamburaj, Krishnamoorthy; Specht, Charles S.; Knaub, Mark A.

doi:10.1016/j.wneu.2020.09.036

Cited by 9 publications

(2 citation statements)

References 13 publications

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“… 3 4 There have been cases reported previously where patients have presented with cauda equina symptoms due to venous congestion from dilated varices. The underlying etiology of cases with venous congestion is more commonly lower limb deep vein thrombosis 5 than from inferior vena cava agenesis as in this case. 6 Although the history of exertion-induced lower limb sensory changes could be attributed to the venous congestion, the acute presentation did not clinically behave like a vascular myelopathy case as there was clinical improvement after steroid administration.…”

Section: Discussionmentioning

confidence: 83%

Acute Venous Congestive Myelopathy in a Patient with Neurosarcoidosis

Guy

2022

J Neurol Surg Rep

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There is a range of differential diagnoses for intramedullary lesions of the conus medullaris, both neoplastic and non-neoplastic. There is a limited role for surgery in a large proportion of these diagnoses, and operative risks can outweigh any benefits of surgery. Here a case is presented of a patient referred to a neurosurgical centre for a biopsy of a presumed neoplastic conus tumour. However through the collaboration of a multidisciplinary team, further diagnoses were considered. After thorough investigation two conditions were diagnosed; venous congestive myelopathy secondary to inferior vena cava agenesis and spinal neurosarcoidosis. This case demonstrates the importance of neurosurgeons retaining a high degree of suspicion for alternative diagnosis to avoid unnecessary surgical risk.

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Section: Discussionmentioning

confidence: 83%

Acute Venous Congestive Myelopathy in a Patient with Neurosarcoidosis

Guy

2022

J Neurol Surg Rep

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“…Many case reports lack details regarding the clinical setting, but it is reasonable to assume that they predominantly originate from specialist clinics or hospitals, as these comprise the majority of reports. Unfortunately, only a limited number of reports indicated whether patients were referred from primary care and the specific reasons for their referral [ 54 , 137 , 211 , 229 , 263 , 274 , 279 , 297 , 374 ]. It has been suggested that non-mechanical back pain may indicate the possibility of extravertebral LBP [ 3 , 464 ].…”

Section: Discussionmentioning

confidence: 99%

Extravertebral low back pain: a scoping review

Kunow,

Freyer Martins Pereira,

Chenot

2024

BMC Musculoskelet Disord

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Background Low back pain (LBP) is one of the most common reasons for consultation in general practice. Currently, LBP is categorised into specific and non-specific causes. However, extravertebral causes, such as abdominal aortic aneurysm or pancreatitis, are not being considered. Methods A systematic literature search was performed across MEDLINE, Embase, and the Cochrane library, complemented by a handsearch. Studies conducted between 1 January 2001 and 31 December 2020, where LBP was the main symptom, were included. Results The literature search identified 6040 studies, from which duplicates were removed, leaving 4105 studies for title and abstract screening. Subsequently, 265 publications were selected for inclusion, with an additional 197 publications identified through the handsearch. The majority of the studies were case reports and case series, predominantly originating from specialised care settings. A clear distinction between vertebral or rare causes of LBP was not always possible. A range of diseases were identified as potential extravertebral causes of LBP, encompassing gynaecological, urological, vascular, systemic, and gastrointestinal diseases. Notably, guidelines exhibited inconsistencies in addressing extravertebral causes. Discussion Prior to this review, there has been no systematic investigation into extravertebral causes of LBP. Although these causes are rare, the absence of robust and reliable epidemiological data hinders a comprehensive understanding, as well as the lack of standardised protocols, which contributes to a lack of accurate description of indicative symptoms. While there are certain disease-specific characteristics, such as non-mechanical or cyclical LBP, and atypical accompanying symptoms like fever, abdominal pain, or leg swelling, that may suggest extravertebral causes, it is important to recognise that these features are not universally present in every patient. Conclusion The differential diagnosis of extravertebral LBP is extensive with relatively low prevalence rates dependent on the clinical setting. Clinicians should maintain a high index of suspicion for extravertebral aetiologies, especially in patients presenting with atypical accompanying symptoms.

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