A Case of Dandy Walker Cyst Variant.

Park, Yong; Sung, Tae Kyung; Kang, Joon Ki

Original Article

Journal of Korean Neurosurgical Society 1978;7(1): 135-144.

Department of Neurosurgery, Catholic Medical College, Seoul, Korea.

ABSTRACT

The "Dandy-Walker syndrome" has been the source of much controversy not only as to its embryogenesis but also concerning the correct diagnosis and surgical management of this disorder. The original description by Dandy and Blackfan emphasized the association of hydrocephalus, posterior fossa cyst and maldevelopment of the cerebellar vermis and later, Taggart and Walker described the genesis of these anomalities to atresia of the foramina of Magendie and Luschka. The Neuroradiologic findings associated with the presence of a Dandy-Walker cyst are pathognomonic. These findings relating to the cystic dilatation of the fourth ventricle which accompanies atresia and its outlets, gave a detailed clinicoanatomical information about the hydrocephalus in the CT scan. The CT scan contributed to the new advanced fields in the diagnosis and surgical management of hydrocephalus combining with the posterior fossa, lesion, because it was easily able to detect the lesion site stereoscopically and also find out the relationship to the involved surrounding area comparing with each of the slice in the CT scan. The purpose of this paper is to attempt to clarify the differentiation of the Dandy-Walker cyst variant from the Dancy-Walker cyst and anatomically detect the damaged brain correlated with the ventricular dilatation on the CT scan. A 7 year-old boy was admitted to the Department of Neurosurgery, Catholic Medical Center on Dec, 22, 1977 with one month history of progressive headache, nausea, vomiting and gait disturbance. On his examination he showed moderate enlargement of head, papilledema, diplopia, horizontal nystagmus, and gait disturbance. We confirmed the diagnosis under the Dandy Walker Cyst Variant by conray ventriclography and CT scan. He underwent lateral ventriculo-peritoneal shunt and then his symptoms progressively improved. He was discharged to his home after the 14th day of hospitalization.