Intractable radicular and low back pain secondary inferior vena cava stenosis associated with Budd-Chiari syndrome: endovascular treatment with cava stenting: case report and review of the literature.
METHODS
The present report describes treatment of enlarged lumbar epidural veins in a patient with Budd-Chiari syndrome presenting with intractable radicular and low back pain.


OBJECTIVE
To present a rare cause of radicular pain. To offer a case successfully to be treated with stenting of inferior vena cava stenosis.


BACKGROUND
Epidural venous engorgements due to inferior vena cava thrombosis have been described previously in the literature. To the authors' knowledge, this is the first case of inferior vena cava stenosis to be treated with stenting.


METHODS
An 27-year-old woman presented with intractable radicular and low back pain refractory to medical treatment. She was diagnosed with Budd-Chiari syndrome for 23 years. A venography revealed severe stenosis at the hepatic portion of the inferior vena cava causing symptomatic lumbar epidural venous engorgements.


RESULTS
Inferior vena cava stenosis was dilatated with endovascular stenting. Her symptoms were completely resolved after this procedure.


CONCLUSIONS
Inferior vena cava stenosis related to hypertrophied caudate lobe producing lumbar epidural venous engorgements should be considered as one of the causes of radicular and low back pain. We could obtain a favorable clinical outcome by handling the primary cause of the venous engorgement.
Bozkurt
Gökhan
G
Institute of Neurological Sciences and Psychiatry, Department of Neurosurgery and Radiology, Hacettepe University, School of Medicine, Ankara, Turkey. gbozkurt@hacettepe.edu.tr
Cil
Barbaros
B
Akbay
Atilla
A
Türk
Cezmi Cağri
CC
Palaoğlu
Selçuk
S
D000328:Adult; D006502:Budd-Chiari Syndrome / Q000150:complications*; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D010148:Intractable Pain / Q000209:etiology*; D011843:Radiculopathy / Q000209:etiology*; D015607:Stents; D014057:Tomography, X-Ray Computed; D014652:Vascular Diseases / Q000150:complications* / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D014682:Vena Cava, Inferior