Innovative neurovascular decompression for chronic intractable hiccups secondary to vertebral artery dolichoectasia: a novel surgical technique. Illustrative case.

Journal of neurosurgery. Case lessons Pub Date : 2025-05-12 DOI:10.3171/CASE2552

Ahmad Abdullah Altayyar, Benjamin Brokinkel, Uta Schick, Panagiotis Fistouris

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Abstract

Background: Chronic continuous hiccups can significantly impair quality of life and may lead to considerable psychological stress in affected patients. Although often idiopathic, hiccups can also be caused by local compression of the brainstem.

Observations: The authors present the case of a female patient with refractory hiccups caused by brainstem compression by vertebral artery dolichoectasia. Complete recovery was achieved through an innovative surgical approach involving microsurgical decompression of the medulla oblongata, which enabled direct visualization of the vertebral artery at its transition from the extradural to intradural space.

Lessons: This case highlights the potential anatomical and structural causes of intractable hiccups, underscores the importance of thorough neuroradiological evaluation, and ultimately advocates for an individualized surgical approach in such cases. https://thejns.org/doi/10.3171/CASE2552.

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创新神经血管减压术治疗椎动脉延张性慢性顽固性呃逆：一种新的外科技术。说明情况。

背景：慢性持续性打嗝会严重影响患者的生活质量，并可能导致相当大的心理压力。虽然打嗝通常是特发性的，但也可以由脑干局部受压引起。观察：作者提出的情况下，顽固性呃逆引起的脑干压迫椎动脉过度扩张的女性患者。通过显微外科手术对延髓进行减压，实现了患者的完全恢复，从而可以直接看到椎动脉从硬膜外间隙到硬膜内间隙的过渡。经验教训：本病例强调了难治性呃呃病的潜在解剖和结构原因，强调了彻底的神经放射学评估的重要性，并最终主张在此类病例中采用个体化手术方法。https://thejns.org/doi/10.3171/CASE2552。

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Journal of neurosurgery. Case lessons

CiteScore

0.40

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0.00%

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