Intractable Hiccup as the Presenting Symptom of Cavernous Hemangioma in the Medulla Oblongata : A Case Report and Literature Review

Journal of Korean Neurosurgical Society 2014³â 55±Ç 6È£ p.379 ~ p.382

ÀÌ°æÈ­(Lee Kyung-Hwa) - Chonnam National University Hwasun Hospital Department of Pathology
¹®°æ¼·(Moon Kyung-Sub) - Chonnam National University Hwasun Hospital Department of Neurosurgery
Á¤¹Î¿µ(Jung Min-Young) - Chonnam National University Hwasun Hospital Department of Radiology
Á¤½Å(Jung Shin) - Chonnam National University Hwasun Hospital Department of Neurosurgery

Abstract

A case of intractable hiccup developed by cavernous hemangioma in the medulla oblongata is reported. There have been only five previously reported cases of medullary cavernoma that triggered intractable hiccup. The patient was a 28-year-old man who was presented with intractable hiccup for 15 days. It developed suddenly, then aggravated progressively and did not respond to any types of medication. On magnetic resonance images, a well-demarcated and non-enhancing mass with hemorrhagic changes was noted in the left medulla oblongata. Intraoperative findings showed that the lesion was fully embedded within the brain stem and pathology confirmed the diagnosis of cavernous hemangioma. The hiccup resolved completely after the operation. Based on the presumption that the medullary cavernoma may trigger intractable hiccup by displacing or compression the hiccup arc of the dorsolateral medulla, surgical excision can eliminate the symptoms, even in the case totally buried in brainstem.

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Brainstem, Cavernous hemangioma, Hiccup, Medulla oblongata, Surgery
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