Microvascular decompression (MVD) is an effective and safe approach for treatinghemifacial spasm (HFS). Postoperative complications may include facial nervepalsy, hearing loss, intracerebral haematoma, and brainstem infarction. Theoccurrence of intracranial cyst following MVD is extremely rare, with few casesdocumented in the literature. Herein, the cases of two patients with HFS whodeveloped ipsilateral cerebellar cyst following MVD are reported. The firstpatient was a 50-year-old male presenting with a 6-year history of HFS on theright side of his face. MVD was performed, and 12 days postoperatively hedeveloped dizziness and nausea. Magnetic resonance imaging (MRI) showed a cystin the ipsilateral cerebellum. Antibiotic treatment provided no benefit, and thecyst was drained. The second patient was a 44-year-old female presenting with a4-year history of HFS on the right side of her face. MVD was performed, and 18days following surgery, she developed dizziness and nausea. MRI showed anipsilateral cerebellar cyst. Conservative treatment was applied and the cystshrunk. At the 2-month follow-up appointment, symptoms were completely resolvedin both patients. Cerebellar cyst is a rare complication following MVD. Timelydiagnosis and appropriate treatment should be emphasized, and surgical treatmentmay be unnecessary.
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