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http://dx.doi.org/10.3340/jkns.2014.55.6.379

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

Lee, Kyung-Hwa (Department of Pathology, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital & Medical School)
Moon, Kyung-Sub (Department of Neurosurgery, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital & Medical School)
Jung, Min-Young (Department of Radiology, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital & Medical School)
Jung, Shin (Department of Neurosurgery, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital & Medical School)
Publication Information
Journal of Korean Neurosurgical Society / v.55, no.6, 2014 , pp. 379-382 More about this Journal
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.
Keywords
Brainstem; Cavernous hemangioma; Hiccup; Medulla oblongata; Surgery;
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1 Porter RW, Detwiler PW, Spetzler RF, Lawton MT, Baskin JJ, Derksen PT, et al. : Cavernous malformations of the brainstem : experience with 100 patients. J Neurosurg 90 : 50-58.
2 Stotka VL, Barcay SJ, Bell HS, Clare FB : Intractable hiccough as the primary manifestation of brain stem tumor. Am J Med 32 : 312-315, 1962
3 Thaci B, Burns JD, Delalle I, Vu T, Davies KG : Intractable hiccups resolved after resection of a cavernous malformation of the medulla oblongata. Clin Neurol Neurosurg 115 : 2247-2250, 2013   DOI
4 Turazzi S, Alexandre A, Bricolo A, Rizzuto N : Opsoclonus and palatal myoclonus during prolonged post-traumatic coma. A clinico-pathologic study. Eur Neurol 15 : 257-263, 1977   DOI
5 Wang CC, Liu A, Zhang JT, Sun B, Zhao YL : Surgical management of brain-stem cavernous malformations : report of 137 cases. Surg Neurol 59 : 444-454; discussion 454, 2003   DOI   ScienceOn
6 Ward BA, Smith RR : Hiccups and brainstem compression. J Neuroimaging 4 : 164-165, 1994   DOI
7 Abla AA, Lekovic GP, Turner JD, de Oliveira JG, Porter R, Spetzler RF : Advances in the treatment and outcome of brainstem cavernous malformation surgery : a single-center case series of 300 surgically treated patients. Neurosurgery 68 : 403-414; discussion 414-415, 2011   DOI
8 al Deeb SM, Sharif H, al Moutaery K, Biary N : Intractable hiccup induced by brainstem lesion. J Neurol Sci 103 : 144-150, 1991   DOI   ScienceOn
9 Arita H, Oshima T, Kita I, Sakamoto M : Generation of hiccup by electrical stimulation in medulla of cats. Neurosci Lett 175 : 67-70, 1994   DOI
10 Eisenacher A, Spiske J : Persistent hiccups (singultus) as the presenting symptom of medullary cavernoma. Dtsch Arztebl Int 108 : 822-826, 2011
11 Lapresle J, Hamida MB : The dentato-olivary pathway. Somatotopic relationship between the dentate nucleus and the contralateral inferior olive. Arch Neurol 22 : 135-143, 1970   DOI   ScienceOn
12 Hassler R : Die neuronalen system der extrapyramidalen myoclonien und deren stereotaktische behandlung in Doose H (ed) : Aktuelle Neuropadiatrie. Stuttgart : Thieme, 1997, pp20-46
13 Johnson DL : Intractable hiccups : treatment by microvascular decompression of the vagus nerve. Case Report. J Neurosurg 78 : 813-816, 1993   DOI
14 Kumral E, Acarer A : Primary medullary haemorrhage with intractable hiccup. J Neurol 245 : 620-622, 1998   DOI
15 Launois S, Bizec JL, Whitelaw WA, Cabane J, Derenne JP : Hiccup in adults : an overview. Eur Respir J 6 : 563-575, 1993
16 Matsuo F, Ajax ET : Palatal myoclonus and denervation supersensitivity in the central nervous system. Ann Neurol 5 : 72-78, 1979   DOI   ScienceOn
17 Mattana M, Mattana PR, Roxo MR : Intractable hiccup induced by cavernous angioma in the medulla oblongata : case report. J Neurol Neurosurg Psychiatry 81 : 353-354, 2010   DOI
18 Musumeci A, Cristofori L, Bricolo A : Persistent hiccup as presenting symptom in medulla oblongata cavernoma : a case report and review of the literature. Clin Neurol Neurosurg 102 : 13-17, 2000   DOI   ScienceOn
19 Oshima T, Sakamoto M, Tatsuta H, Arita H : GABAergic inhibition of hiccup-like reflex induced by electrical stimulation in medulla of cats. Neurosci Res 30 : 287-293, 1998   DOI
20 Park MH, Kim BJ, Koh SB, Park MK, Park KW, Lee DH : Lesional location of lateral medullary infarction presenting hiccups (singultus). J Neurol Neurosurg Psychiatry 76 : 95-98, 2005   DOI
21 Pechlivanis I, Seiz M, Barth M, Schmieder K : A healthy man with intractable hiccups. J Clin Neurosci 17 : 781-783, 2010   DOI