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Dandy Walker malformation

Case contributed by Hoe Han Guan
Diagnosis almost certain

Presentation

Antenatal scan noted hydrocephalus and enlarged posterior fossa.

Patient Data

Age: 4 days
Gender: Female
mri

Enlarged posterior fossa with torcular-lambdoid inversion (torcular lying above the level of the lambdoid due to abnormally high tentorium).
The overall size of the skull is increased. 
A large fluid attenuating cystic mass occupies the posterior fossa which is communicating directly with the fourth ventricle.
Cerebellum and vermian hypoplasia with bilateral rudimentary remnant of cerebellum which are pushed anterolaterally by the cystic mass.
The aqueduct of Sylvius appears narrowed and prominent obstructive hydrocephalus.
Dysgenesis of corpus callosum as it appears smaller in size.

Case Discussion

MRI of an infant demonstrates features consistent with a Dandy-Walker malformation with associated aqueduct stenosis and obstructive hydrocephalus

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