Introduction: Vertebral artery compressing the medulla and causing intractable vomiting has only been reported once previously. We report a case of a 69 year-old woman with intractable nausea and vomiting causing a 50 pound weight loss and who failed medical management and whose symptoms were completely reversed following microvascular decompression (MVD).
Methods: Case report with 2 year follow up
Results: The postoperative course was uneventful, patient was discharged from the hospital without any anti-emetic medication and was documented to regain weight. At a 2-year postoperative follow up she had achieved a normal body mass index.
Conclusions: This case demonstrated the importance of neurological investigations in the isolated intractable vomiting patient without a clear evidence of peripheral cause and including a central nervous system etiology on the differential, and the role of MVD in achieving cure.
Patient Care: Will help to improve the recognition of central causes of intractable nausea and vomiting, especially in patients without clear GI etiology.
Learning Objectives: By reading this paper, reader should be able to: 1) consider a central cause for intractable nausea and vomiting 2) recognize MVD as an option for medullary compression by vertebral artery