Thrombosed Lumbar Epidural Varix Mimicking Lumbar Disc Herniation: Case Report Adem Bursali; Goktug Akyoldas MD; Ahmet Burak Guvenal MD; Can Yaldiz; Onur MD Yaman [Institution]

Introduction Results Learning Objectives Figure 1 Lumbar epidural varices may mimic Discussion: Mechanism of the Thrombosed lumbar epidural varices lumbar disc herniation by causing lumbar varix is exactly unknown, but may mimic lumbar disc herniations radiculopathy. In various increased venous pressure due to both radiologically and clinically and publications, the incidence rate of the blockage of blood flowing therefore must be kept in mind in the lumbar epidural varices was through to vena cava system is differential diagnosis of lumbar disc reported as 0.067%-1.2% . The thought as the main reason. Locally herniations diagnosis of this entity is usually factors such as herniated disc also made intraoperative. In this play a role in the etiology of venous References Preoperative T2-axial (A) and T2-sagittal presentation, we report a patient of varix by causing compression. In (B) magnetic resonance imaging show hyperintense cystic lesions compressing lumbar epidural varix presented with many reports, lumbar varices have the right spinal root. The yellow white radiculopathy symptoms and been found in association with spinal shows the lesion mimicked a lumbar disc herniation. stenosis, spondyloarthropathy and Figure 2 ankylosing spondylitis. Though Methods thrombosed varices are often saw Case Report: A 26-years-old male hyperintense on T1-weighted and T2 patient presented with low back and -weighted images, they can be saw severe right leg pain. He was hypointensity on T2-weighted MRI healthy otherwise. Lasègue's sign sequences according to intensity of was positive and loss of sensation in the thrombosis. Surgery is the best L5 dermatome was noted. There treatment for the symptomatic spinal was no motor deficit. Sacrolumbar epidural varices. The gaols of the Preoperative T1-axial (A) and T1-sagittal (B) magnetic reso¬nance imaging show MRI showed a lesion in the epidural surgery should be the hypointense lesions compressing the right space at upper L5 level just decompression of the dural sac spinal root. The white arrow shows the posterior to L5 vertebra on the right and/or spinal nerve roots, and lesion appearing as hypointense on the T1- elimination of dilated veins’ irritation. Figure 3 weighted images and hyperintense on the T2-weighted images (Figure Conclusions 1-2).The patient underwent surgery Symptomatic epidural varices are and right L4-5 hemilaminectomy was rare entities and clinically and performed. A well shaped, brown radiologically mimic lumbar disc mass lesion, which compressed the herniation. Spinal epidural varices right L5 nerve root was identified should be kept in mind in the during surgery. The nerve root was differential diagnosis of the lumbar Fig 3. Postoperative T2-axial (A) and T2- decompressed by shrinking the disc herniation. sagittal (B) magnetic reso¬nance slices lesion with bipolar show the absence of the lesion thermocoagulation and excision. The patient’s complaints