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Citation:
Botz B, Jones J, Picker B, et al. Spinal epidural venous plexus congestion. Reference article, Radiopaedia.org (Accessed on 01 May 2024) https://radiopaedia.org/articles/85085
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.
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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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1. Tuan A, Nabavizadeh S, Pukenas B, Mohan S, Learned K. Reversible Dilatation of Lumbar Epidural Venous Plexus Secondary to Pelvic Venous Compression: Mimicker of Pathology. BJR|case Reports. 2017;3(1):20150287. doi:10.1259/bjrcr.20150287 - Pubmed
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3. Donmez F. Epidural Venous Plexus Engorgement: What Lies Beneath? Case Reports in Radiology. 2015;2015:1-3. doi:10.1155/2015/965106 - Pubmed
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4. Ju J, Ha H, Jung C, Kim H, Lee C, Kim J. Patterns of Epidural Venous Varicosity in Lumbar Stenosis. Korean J Spine. 2012;9(3):244-9. doi:10.14245/kjs.2012.9.3.244 - Pubmed
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5. Park S, Lee I, Song Y, Moon J, Song J, Kang H. Dilatation of the Spinal Epidural Venous Plexus in Patients with Prominent Epidural Fat. Br J Radiol. 2016;89(1063):20160064. doi:10.1259/bjr.20160064 - Pubmed
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6. Wong T, Gridley D, Feiz-Erfan I. Epidural Venous Plexus Engorgement Due to Inferior Vena Cava Thrombosis Resulting in Cauda Equina Syndrome: Case Report and Literature Review. Surg Neurol Int. 2018;9(1):129. doi:10.4103/sni.sni_115_18 - Pubmed
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7. Tello Díaz C, Allegue Allegue N, Gil Sala D, Gonçalves Martins G, Boqué Torremorell M, Bellmunt Montoya S. Cauda Equina Syndrome Caused by Epidural Venous Plexus Engorgement in a Patient with May-Thurner Syndrome. Ann Vasc Surg. 2019;60:480.e7-480.e11. doi:10.1016/j.avsg.2019.04.002 - Pubmed
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