Arachnoid cysts involving the cerebellopontine angle are an unusual cause of hemifacial spasm. The case is reported of a 71-year old woman presenting with a right hemifacial spasm and an ipsilateral arachnoid cyst. Preoperative magnetic resonance imaging findings suggested a neurovascular compression caused by displacement of the facial-acoustic complex and the anterior inferior cerebellar artery by the cyst. Cyst excision and microvascular decompression of the facial nerve achieved permanent relief. The existing cases of arachnoid cysts causing hemifacial spasm are reviewed and the importance of a secondary neurovascular conflict identification and decompression in these cases is highlighted.
Los quistes aracnoideos del ángulo pontocerebeloso son una causa inusual de espasmo hemifacial. Describimos el caso de una mujer de 71 años que presentaba un espasmo hemifacial derecho y un quiste aracnoideo ipsilateral. Los hallazgos de la resonancia magnética preoperatoria indicaban una compresión neurovascular provocada por el desplazamiento del complejo nervioso facial-acústico y de la arteria cerebelosa anteroinferior por el quiste. La extirpación del quiste y la descompresión microvascular del nervio facial consiguieron un alivio permanente del espasmo. Se revisan los casos conocidos de espasmo hemifacial secundario a un quiste aracnoideo y se resalta la importancia de identificar un conflicto neurovascular secundario y de realizar una descompresión en estos casos.
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