Cauda Equina Syndrome from Spinal Spinal Venous Congestion Secondary to Collateral Vein Enlargement from Occluded Interior Vena Cava Treated with IVC Stent (P6.078)

31-year old male presented with complaints of shoulder, neck and upper back pain, numbness of the genitalia, and difficulty voiding. He described "knots around the muscles of the chest." Patient was unable to identify a causative event. There was overall feeling of weakness. The patient reported a sensation of numbness in the genitalia over the same period. He was still capable of having erections, but ejaculations only occurred intermittently. Patient mentioned he experienced difficulty with voiding without incontinence... His medical history is significant idiopathic retroperitoneal fibrosis, for which he underwent open laparotomy with adhesiolysis in 2014. Physical examination revealed an overweight young male. Sensory and motor functions were intact with normal power and tone. Reflexes were present and symmetrical bilaterally. Plantar responses were down-going. Genital examination showed intact sensation and cremasteric reflex; rectal sphincter tone was normal with intact perineal sensation to touch and pain. Clinical history and examination prompted a suspicion of cauda equine syndrome. MRI evaluation of the lower thoracic and lumbar spine showed prominent epidural vasculature in the lumbar spine, likely representing collateral venous drainage due to distal occlusion of the inferior vena cava (IVC) as a consequence of retroperitoneal fibrosis. Methods: He underwent successful recanalization angioplasty of the ICV and bilateral iliac veins with stenting of IVC and both...
Source: Neurology - Category: Neurology Authors: Tags: Cerebrovascular Disease: Spinal Cord Involvement and Traumatic Brain Injury Source Type: research