case_images: PMC10917428_01
case_images: a Time-resolved contrast-enhanced axial magnetic resonance angiography (MRA) demonstrates a beak sign (arrow) secondary to severe LRV narrowing between the aorta and superior mesenteric artery. b Time-resolved contrast-enhanced sagittal MRA demonstrates retrograde flow through the LRV (arrow) and a decreased aortomesenteric distance (red line). c Time-resolved contrast-enhanced sagittal MRA demonstrates an enlarged L2LV (arrow) and a congested spinal EVP (arrowhead). d Axial reformat of the dynamic time-resolved MRA demonstrates retrograde flow through the enlarged L2LV (arrow) with enhancement and congestion of the spinal EVP (arrowhead). e Left second lumbar venogram demonstrates retrograde flow through the L2LV (arrow) with congestion of the spinal EVP (arrowheads). f Left renal venogram post-embolization demonstrates complete coil occlusion of the L2LV (arrow) with no further flow into the spinal EVP.
case_images: crn-2024-0016-0001-537705_F02.jpg
case_images: PMC10917428_01_crn-2024-0016-0001-537705_F02.jpg
case_images: F2
case_images: EVP suggesting congestion (shown in Fig. 2b-d). Eventually 4 years after the onset of her early morning headaches, the patient underwent conventional venography that confirmed NP with spinal EVP congestion (shown in Fig. 2e). The L2LV was then coil embolized and a follow-up venogram from the LRV demonstrated no further flow into the L2LV or the EVP (shown in Fig. 2f).