Delayed hemorrhage after microvascular decompression in a hemifacial spasm patient associated with neurosyphilis.

Microvascular decompression is an effective treatment for hemifacial spasm. Hemorrhage is one of the complications of microvascular decompression. However, delayed hemorrhage is very rare. Here, we report a case of ipsilateral cerebellar hemorrhage at day seven following microvascular decompression. A 45-year-old woman presented with left HFS for the previous two years. Diagnostic testing demonstrated the presence of neurosyphilis. Brain magnetic resonance image was unremarkable on presentation. She received microvascular decompression and her hemifacial spasm completely resolved after surgery. At day seven post-operatively, the patient presented with a sudden onset headache. Emergency computed tomography scan showed a cerebellar hemorrhage. A suboccipital craniotomy was performed and a cerebellar hematoma was evacuated. The delayed hemorrhage was attributed to possible microaneurysm from syphilis. [ABSTRACT FROM AUTHOR]