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

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.