Hiccup and neurosurgeons: a report of 4 rare dorsal medullary compressive pathologies and review of the literature

Surg Neurol. 2007 Apr;67(4):395-402; discussion 402. doi: 10.1016/j.surneu.2006.10.070.

Abstract

Objective: The aim of this study was to present 4 rare cases of medullary compressive lesions presenting with IH, to discuss the indications for neurosurgical decompression in such cases, and to review the possible etiologies of IH briefly.

Methods: The reported cases include (1) a 19-year-old adolescent boy and a 21-year-old man with Chiari I malformation and cervical syrinx compressing or tightening the cervico-medullary junction; (2) a 35-year-old man with ependymoma extending from the lower half of the fourth ventricle to C1/C2 junction and compressing this part of the medulla; and (3) a 16-year-old adolescent boy who was referred to the emergency department in severe distress because of IH, occurring as a result of a distal PICA aneurysm located on the floor of the lower triangle of the fourth ventricle.

Results: Surgical decompression in all the cases was successful in withholding the hiccups.

Conclusion: The dorsal medullary area is not an unusual location for genesis of hiccup. When encountering a case of IH, appropriate CNS imaging studies should be included in the evaluation protocol.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Arnold-Chiari Malformation / diagnosis
  • Arnold-Chiari Malformation / pathology*
  • Arnold-Chiari Malformation / therapy
  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / pathology*
  • Brain Neoplasms / therapy
  • Cerebellum / blood supply*
  • Ependymoma / diagnosis
  • Ependymoma / pathology*
  • Ependymoma / therapy
  • Hiccup / etiology*
  • Humans
  • Intracranial Aneurysm / diagnosis
  • Intracranial Aneurysm / pathology*
  • Intracranial Aneurysm / therapy
  • Male
  • Medulla Oblongata