{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T08:10:14Z","timestamp":1756282214100,"version":"3.44.0"},"reference-count":7,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,12,23]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>Budd-Chiari syndrome with obstruction in the inferior vena cava causes increased venous pressure in the azygous-hemiazygous system and paravertebral venous plexus, which is transmitted to the epidural venous plexus, devoid of the valves. It causes epidural venous plexus engorgement and venous congestion and may present rarely with low back pain or radiating pain. However, patients developing lower limb weakness as a complication of Budd-Chiari syndrome is an infrequent and severe presentation. Herein, we describe a case of Budd-Chiari syndrome with chronic inferior vena cava thrombosis in a patient in his 40s presenting with lower limb weakness, which improved after inferior vena cava stenting. In patients with back pain or lower limb weakness due to epidural venous engorgement and venous congestion, inferior vena cava occlusion secondary to Budd-Chiari syndrome should always be kept in mind, which can be treated successfully with endovascular stenting. Also, early intervention in Budd-Chiari syndrome can prevent permanent neurological deficits and the long-term complications of cirrhosis.<\/jats:p>","DOI":"10.1136\/bcr-2024-263306","type":"journal-article","created":{"date-parts":[[2025,1,4]],"date-time":"2025-01-04T22:50:33Z","timestamp":1736031033000},"page":"e263306","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Congestive myelopathy secondary to epidural venous engorgement and venous congestion in a patient with Budd-Chiari syndrome and its management through inferior vena cava stenting"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3317-8353","authenticated-orcid":false,"given":"Biswajit","family":"Sahoo","sequence":"first","affiliation":[{"name":"Radiodiagnosis and Interventional Radiology, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manas Kumar","family":"Panigrahi","sequence":"additional","affiliation":[{"name":"Gastroenterology, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shubham","family":"Gupta","sequence":"additional","affiliation":[{"name":"Gastroenterology, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1146-2302","authenticated-orcid":false,"given":"Manoj Kumar","family":"Nayak","sequence":"additional","affiliation":[{"name":"Radiodiagnosis and Interventional Radiology, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,1,4]]},"reference":[{"key":"2025082700304659000_18.1.e263306.1","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/S0025-6196(12)62109-0","article-title":"Classification of hepatic venous outflow obstruction: ambiguous terminology of the Budd-Chiari syndrome","volume":"65","author":"Ludwig","year":"1990","journal-title":"Mayo Clin Proc"},{"key":"2025082700304659000_18.1.e263306.2","article-title":"Role of Inferior Vena Cava (IVC) Recanalization in Patients with Back Pain, Secondary to IVC Obstruction in Budd-Chiari Syndrome","volume":"13","author":"Kubihal","year":"2023","journal-title":"Diagn (Basel)"},{"key":"2025082700304659000_18.1.e263306.3","doi-asserted-by":"crossref","first-page":"467","DOI":"10.3171\/2015.1.SPINE14515","article-title":"Myelopathy-mimicking symptoms of epidural venous engorgement and syringomyelia due to inferior vena cava stenosis at the thoracolumbar junction in a patient with Budd-Chiari syndrome","volume":"23","author":"Lee","year":"2015","journal-title":"J Neurosurg Spine"},{"key":"2025082700304659000_18.1.e263306.4","first-page":"49","article-title":"Venous Congestive Myelopathy due to Chronic Inferior Vena Cava Thrombosis Treated with Endovascular Stenting: Case Report and Review of the Literature","volume":"8","author":"Carvalho","year":"2015","journal-title":"J Vasc Interv Neurol"},{"key":"2025082700304659000_18.1.e263306.5","doi-asserted-by":"crossref","first-page":"E383","DOI":"10.1097\/01.brs.0000219516.54500.97","article-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","volume":"31","author":"Bozkurt","year":"2006","journal-title":"Spine (Phila Pa 1986)"},{"key":"2025082700304659000_18.1.e263306.6","doi-asserted-by":"crossref","first-page":"2419","DOI":"10.1097\/01.brs.0000144354.36449.2f","article-title":"Epidural Venous Plexus Enlargements Presenting With Radiculopathy and Back Pain in Patients With Inferior Vena Cava Obstruction or Occlusion","volume":"29","author":"Paksoy","year":"2004","journal-title":"Spine (Phila Pa 1986)"},{"key":"2025082700304659000_18.1.e263306.7","doi-asserted-by":"crossref","first-page":"201","DOI":"10.3171\/2011.10.SPINE1121","article-title":"Cauda equina syndrome secondary to an absent inferior vena cava managed with surgical decompression","volume":"16","author":"Ghiassi","year":"2012","journal-title":"J Neurosurg Spine"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-263306","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:30:54Z","timestamp":1756279854000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-263306"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":7,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,4]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/bcr-2024-263306"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-263306","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}