Sweeney Jared, Bodman Alexa, Hall Walter A
Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, New York, USA.
Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, New York, USA.
World Neurosurg. 2018 Apr;112:182-185. doi: 10.1016/j.wneu.2018.01.139. Epub 2018 Jan 31.
Brain abscesses are well-known to neurologic surgeons with well-recognized presentations, which include seizures, neurologic deficit, and headache. Rare symptoms may lead to a delay in diagnosis, which can be life threatening in the setting of a brain abscess.
We present the case of a 46-year-old male with intractable hiccups found to have an abscess of the right basal ganglia. The brain abscess was treated by frameless stereotactic-guided aspiration. The patient's hiccups improved after surgical aspiration and medical management.
A comprehensive literature review confirmed brain abscess as a rare cause of intractable hiccups. In addition, there are few reports of lesions of the basal ganglia causing intractable hiccups. Aspiration and medical therapy resulted in resolution of the hiccups. Knowledge of the hiccup reflex arc and unusual presentation of basal ganglia lesions may shorten time to diagnosis.
脑脓肿对于神经外科医生来说并不陌生,其临床表现已得到广泛认可,包括癫痫发作、神经功能缺损和头痛。罕见症状可能导致诊断延迟,在脑脓肿的情况下这可能危及生命。
我们报告一例46岁男性,顽固性呃逆,经检查发现右侧基底节区有脓肿。脑脓肿采用无框架立体定向引导穿刺抽吸治疗。手术抽吸和药物治疗后,患者的呃逆症状有所改善。
全面的文献综述证实脑脓肿是顽固性呃逆的罕见原因。此外,关于基底节区病变导致顽固性呃逆的报道很少。抽吸和药物治疗使呃逆症状得到缓解。了解呃逆反射弧以及基底节区病变的异常表现可能会缩短诊断时间。