title: 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.
abstract: 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.
authors.affiliation: Institute of Neurological Sciences and Psychiatry, Department of Neurosurgery and Radiology, Hacettepe University, School of Medicine, Ankara, Turkey. gbozkurt@hacettepe.edu.tr
authors.forename: Gökhan
authors.initials: G
authors.lastname: Bozkurt
authors.forename: Barbaros
authors.initials: B
authors.lastname: Cil
authors.forename: Atilla
authors.initials: A
authors.lastname: Akbay
authors.forename: Cezmi Cağri
authors.initials: CC
authors.lastname: Türk
authors.forename: Selçuk
authors.initials: S
authors.lastname: Palaoğlu
mesh_terms: 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