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


CONCLUSIONS
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.
Amirjamshidi
Abbass
A
Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran 19585, Iran. abamirjamshidi@yahoo.com
Abbassioun
Kazem
K
Parsa
Khosrow
K
D000293:Adolescent; D000328:Adult; D001139:Arnold-Chiari Malformation / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D001932:Brain Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D002531:Cerebellum / Q000098:blood supply*; D004806:Ependymoma / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D006606:Hiccup / Q000209:etiology*; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D008297:Male; D008526:Medulla Oblongata