Traumatic venous varix causing sciatic neuropathy: case report.
OBJECTIVE
Sciatic neuropathy rarely presents in nonpenetrating trauma because of protection of the nerve by the pelvis, the gluteal muscles, and the tissues in the posterior thigh. We present the case of a patient who fell and subsequently developed a traumatic venous varix of the inferior gluteal vein that caused compression sciatic neuropathy.


METHODS
Seven days after a fall onto her right buttock, the patient developed a painful burning paresthesia in her leg and numbness on the dorsum of her foot. Numerous studies ruled out lumbar spine pathological abnormalities as the cause of the pain. Conventional magnetic resonance imaging revealed a lesion adjacent to the sciatic nerve. Gradient echo and two-dimensional time-of-flight magnetic resonance imaging sequences confirmed this to be a vascular lesion originating from the inferior gluteal vein and compressing the sciatic nerve.


METHODS
Operative resection obliterated the venous varix, thereby relieving the patient's pain and neurological deficit.


CONCLUSIONS
No case of a traumatic venous varix of the inferior gluteal vein compressing the sciatic nerve has been reported to date. Surgical resection was successful in obliterating the lesion and relieving the symptoms.
Maniker
Allen
A
Department of Neurological Surgery, New Jersey Medical School, 90 Bergen Street, 8th Floor, Newark, NJ 07103, USA. maniker@umdnj.edu
Thurmond
James
J
Padberg
Frank T
FT
Blacksin
Marcia
M
Vingan
Roy
R
D000058:Accidental Falls; D000368:Aged; D002081:Buttocks / Q000098:blood supply*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009408:Nerve Compression Syndromes / Q000209:etiology* / Q000601:surgery; D012584:Sciatic Nerve / Q000473:pathology* / Q000601:surgery; D020426:Sciatic Neuropathy / Q000209:etiology* / Q000601:surgery; D014648:Varicose Veins / Q000209:etiology* / Q000601:surgery; D014947:Wounds and Injuries / Q000150:complications* / Q000601:surgery