Chronic cough caused by cerebellar tonsillar herniation: a case report

Area of Science:

• Neurology
• Otolaryngology
• Gastroenterology

Background:

• Chronic cough typically stems from respiratory or gastroesophageal issues.
• Central nervous system causes are rare, and cerebellar tonsillar herniation usually presents with neurological symptoms, not isolated cough.

Purpose of the Study:

• To investigate the potential of cerebellar tonsillar herniation as an isolated cause of chronic cough.
• To highlight diagnostic approaches for rare etiologies of chronic cough.

Main Methods:

• A case presentation of a 61-year-old woman with a year-long cough.
• Comprehensive evaluations including imaging (CT, MRI) and a water swallow test.
• Surgical intervention (posterior fossa decompression) followed by long-term follow-up.

Main Results:

• Initial investigations for common causes of cough were negative.
• Magnetic resonance imaging confirmed cerebellar tonsillar herniation (10-mm descent).
• Post-surgical resolution of cough with sustained remission at one year.

Conclusions:

• Cerebellar tonsillar herniation can manifest solely as chronic cough, especially after excluding common causes.
• Simple bedside tests like the water swallow test are crucial in multidisciplinary assessments.
• Cerebellar tonsillar herniation should be considered in the differential diagnosis of refractory chronic cough.