Dandy Walker malformation

Case contributed by Dr Prashant Mudgal

Presentation

Irritable child with excessive crying. Unable to stand or walk without support.

Patient Data

Age: 2 years
Gender: Female
CT

A large posterior fossa cyst elevating the tentorium and straight sinus. The hypoplastic vermis is everted over the posterior fossa cyst. The cerebellar hemispheres with a winged appearance and brainstem are hypoplastic. Thinned occipital bone with occipital bossing is seen . Hypoplastic cerebellar hemispheres.

Findings are suggestive of Dandy Walker Malformation

Annotated image

Sagittal Image shows a large posterior fossa cyst elevating the tentorium and sinus rectus (red arrow). The hypoplastic vermis is everted over the posterior fossa cyst (yellow arrow). The cerebellar hemispheres and brainstem are hypoplastic (green arrow). Thinned occipital squama is seen (blue arrow).
Axial image shows hydrocephalus, a large cerebrospinal fluid cyst in the posterior fossa and hypoplastic cerebellar hemispheres with a winged appearance (white arrowheads).

Case Discussion

Dandy Walker malformation is a rare congenital malformation of posterior fossa structures which can be diagnosed on antenatal ultrasonography. Ususally presents in early childhood with delayed motor milestones or with symptomatic intracranial hypertension.

Close imaging differential include:

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Case information

rID: 51728
Case created: 5th Mar 2017
Last edited: 7th Mar 2017
Tag: pm
Inclusion in quiz mode: Included

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