Abnormal Venous Plexus around Sciatic Nerve, a Rare Cause of Piriformis Syndrome

Piriformis syndrome is uncommon clinical condition characterized by paresthesias and pain in the buttock that commonly radiate into the posterior thigh resulting from sciatic nerve entrapment at the greater sciatic notch. Piriformis syndrome is usually caused by sciatic nerve entrapment at the greater sciatic notch. It is usually under diagnosed because of lack of reliable clinical and radiographic features. Mechanical cause for neuropathy in most of the cases reported in the literature was hematoma formation and subsequent scarring around the nerve following blunt injury to the gluteal region. The other rare cause of compression of the nerve are myositis ossificans of piriformis muscle, aneurysm of inferior gluteal artery, muscular dystonias etc. We report an interesting case of Piriformis syndrome in a 45 year old male in whom there was abnormal venous plexus around sciatic nerve causing compression of the nerve. Patient was treated successfully by excision of the abnormal venous plexus.