Venous congestive myelopathy is a spinal cord disorder associated with severe venous congestion

Clinical features:

(1) spinal vascular disease with venous congestion

(2) progressive myelopathy, with symptoms varying with level of the spinal cord affected

(3) T2 hyperintensity in the spinal cord on MRI. This may take the "black butterfly" sign.

(4) exclusion of other spinal cord disorders (sarcoidosis, tumor, other)


The vascular disease is often an arteriovenous malformation with shunt or fistula.


Symptoms may be exacerbated by exercise.


The venous congestion may result in spinal cord necrosis if it goes untreated.

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