Objective and importance: A rare case of bilateral cerebellopontine angle (CPA) arachnoid cysts (ACs), accompanied by cerebellar tonsillar displacement toward the foramen magnum, is presented.
Clinical presentation: A 45-year-old woman presented with progressive dysphagia, vertigo, and truncal ataxia. Magnetic resonance imaging revealed bilateral CPA ACs and cerebellar tonsillar displacement.
Intervention: The right CPA AC was excised via a suboccipital approach. Decompression of the foramen magnum and duraplasty were also performed.
Conclusion: The case reported here is the first case of bilateral CPA ACs. Decompression of the foramen magnum and excision of the cyst resulted in complete relief of symptoms.