Spinal epidural venous plexus congestion

Last revised by Jeremy Jones on 30 Apr 2024

Spinal epidural venous plexus congestion or dilatation is typically a complication of other pathologies. 

Radiculopathy caused by the dilated epidural veins is not uncommon 1. More severe symptoms such as cauda equina compression syndrome have been reported 6, 7.

Several spinal and pelvic diseases can result in secondary epidural venous engorgement:

As the vertebral venous system is valveless, extraspinal venous congestion can rapidly involve these veins 1. The cause for this can be a significant decrease of local venous drainage due to a multitude of reasons including inferior vena cava thrombosis 6.

MRI is the method of choice for imaging spinal epidural venous plexus pathology. Axial and sagittal plane T2-weighted sequences usually clearly demonstrate the engorged epidural veins and effacement of CSF spaces 1,2. The distended venous plexus should not be mistaken for mass, disc herniation, or arteriovenous fistulisation. 

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