Hugely dilated/partially calcified epidural varicose vein caused intraspinal neural compression/sciatica.

BACKGROUND

A patient presented with lumbago/sciatica attributed to a magnetic resonance (MR)-documented hugely dilated, partially calcified, and extrinsically compressive epidural varicose vein (EVV).

CASE DESCRIPTION: A 36-year-old male presented with 2 months of lumbago-sciatica; the only finding was a positive left-sided straight leg sign to 50°. The MR imaging demonstrated a hugely dilated, branching pattern flow void that caused marked displacement/compression of thecal sac and left S1 nerve root. The X-rays and computed tomography (CT) studies additionally showed a linear "string of beads" pattern of calcification at the L5/S1 level. Intraoperatively, an encapsulated, hugely dilated, compressive epidural vein was encountered; partial vein coagulation and gross total removal decompressed the neural elements. He recovered normal neurological function within 1 post-operative month.

CONCLUSION

A 36-year-old male presented with left-sided sciatica attributed to an MR and CT documented hugely dilated, partially calcified L5/S1 EVV. Once the EVV was coagulated and removed, the patient's symptoms resolved.