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Dandy–Walker malformation

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675: 53: 92: 1548:, and instead it is mostly the cisterna magna that is enlarged (sometimes diagnosed as "mega cisterna magna"). In 1999, Calabró et al. first used the phrase Dandy–Walker continuum when referring to proposals that a condition known as Blake's pouch cyst falls under the umbrella of the Dandy–Walker complex proposed by Barkovich. These additional terms are mostly discouraged by modern authors due to additional confusion and complexity to the diagnosis of DWM. 441:. Individuals with these features tend to have developmental delay or seizures. Those without any other central nervous system abnormalities tend to have normal or close-to-normal intellectual development. A 2003 review found that moderate-to-severe intellectual disability and non-DWM brain abnormalities were only present in those with the most severe cerebellar vermis malformations (less than two 938: 3476: 341:(ETV) is a less invasive option for patients older than 1 year. Posterior fossa shunts are most effective (80% of the time) but carry the highest risk of complications, while ETV is least effective but has the least risk of complications. The mortality rate is roughly 15%, mostly due to complications from hydrocephalus or its treatment, which can include 1038:(narrowing of the passage between the third and fourth ventricles) does not seem to be a factor in DWM. It is usually open, and shunts placed in the posterior fossa cyst almost always drain all above ventricles. When it is present, it may be the result of compression from a herniated vermis or cyst or an associated developmental abnormality. 1090:(the space behind the cerebellum), though the specific degree of hypoplasia or cystic enlargement for diagnosis of DWM is not agreed upon. Additionally, there are several similar conditions which have at various times been grouped with DWM on a continuum by some authors and separated as distinct by others, further complicating diagnosis. 701:. A large number of genetic conditions can result in the anomaly. In a large portion of DWM cases, the condition is identified in the person affected, however in most cases the cause is not identified. At least 21% of those with DWM have a sibling with the malformation, and at least 16% have a parent with the malformation. 1543:
once. In 1976, Harwood-Nash and Fitz proposed the term Dandy–Walker variant (DWV) for a malformation in which the posterior fossa is not enlarged but the cerebellar vermis is hypoplastic. In 1989, Barkovich et al. proposed the term Dandy–Walker complex (DWC) to include classic DWM and DWV (under type
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Mortality rates from DWM are roughly 15%. In a study of Dandy–Walker variant (DWV), a mortality rate of 12.5% was observed. The most common cause of death is complications from hydrocephalus or its treatment. Untreated hydrocephalus can lead to increased intracranial pressure and brain damage. Shunts
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beneath it, and instead it is mostly the cisterna magna that is enlarged. In this type, the hypoplasia of the cerebellar vermis does not reach past the horizontal midline of the fourth ventricle, and the posterior fossa is also not as large. The authors noted that this form would previously have been
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are also possible and can lead to mortality. Shunts in the fourth ventricle (cystoperitoneal shunts, or CP shunts) have a generally high rate of successful cyst and ventricle size reduction, especially in the cyst (at least 80%). With a shunt in the lateral ventricles (ventriculoperitoneal shunt, or
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by the malformation. However, a CP shunt almost always drains both the fourth and lateral ventricles in DWM, and according to strict definitions of the malformation, the aqueduct should be assumed open, though imaging is important to confirm this. Many authors therefore recommend the CP shunt as the
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may also be used if MRI is unavailable, but it provides less detail. Klein et al. (2003) suggested that a suspected diagnosis based on CT or ultrasound should not be confirmed until an MRI is performed, due to the large number of conditions that can present highly similarly and confound diagnosis.
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Despite the hypoplastic cerebellar vermis, just over half of individuals with DWM (between 27% and 84%) do not appear to have significant intellectual disability or developmental delay. However, many of the genetic conditions associated with DWM can present with developmental delay and other brain
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Due to the inconsistency of the presence of hydrocephalus in DWM, Spennato and Klein suggested that it should not be considered a criterion for DWM. Klein's criteria differed from Spennato's mainly in that it required no apparent cerebellar hemisphere hypoplasia, but it may also have required the
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is not a contraindication, however. ETV has a more modest success rate than shunts, as the hole often closes over. It is more likely to fail in younger patients (below one year), and its effects on the developing brain are not yet known. Cysts posterior to the cerebellum, presenting in children
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are the mainstay of treatment. However, those with DWM have a higher rate of shunt-related complications than other patients with hydrocephalus (mainly due to the unconventional anatomy). One explanation for a failure of a shunt to reduce intracranial pressure in DWM has been that the cyst may
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when referring to proposals that a condition known as Blake's pouch cyst falls under the umbrella of the Dandy–Walker complex proposed by Barkovich. Later authors would put these terms and systems under intense scrutiny and state that they added considerable confusion to the diagnosis of DWM.
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in the postnatal period. Hydrocephalus occurs in an estimated 80% of patients with classic DWM. This usually presents within the first year of life (85% of the time), most often within the first three months. Signs of hydrocephalus in infants include increasing head size, vomiting, excessive
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The prevalence of DWM is estimated at between 1 in 25,000 to 1 in 50,000. DWM is the cause of around 4.3% of cases of congenital hydrocephalus and 2.5% of all cases of hydrocephalus. At least 21% of those with DWM have a sibling with the malformation, and at least 16% have a parent with the
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Sasaki-Adams, Deanna; Elbabaa, Samer K.; Jewells, Valerie; Carter, Lori; Campbell, Jeffrey W.; Ritter, Ann M. (September 2008). "The Dandy-Walker variant: a case series of 24 pediatric patients and evaluation of associated anomalies, incidence of hydrocephalus, and developmental outcomes".
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on the forward surface of the fourth ventricle, which expand and roll over to fuse in the midline to form the cerebellar vermis by the 15th week. If this process does not complete, the cerebellar vermis will not form fully. This long period of development of the cerebellar vermis makes it
1406:. Spennato et al. therefore recommend a flow-regulating or anti-syphon valve. On the other hand, VP shunts have a lower rate of complications than CP shunts and are recommended initially by some. However, they are less effective in DWM, and the elevated position of the 1433:
of the posterior fossa and excision of the cystic membrane was used, which was often unsuccessful in preventing cyst reformation and carried a degree of mortality. This may still be reserved for patients with repeated shunt failures/infections.
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Treatments for any other symptoms are generally focussed on the specific condition involved and may include supported education, physical therapy or other services. Genetic counselling may be offered to parents for future conceptions.
1012:(CSF) to escape into the subarachnoid space of the posterior fossa. However, later studies found that these foramina are usually open in DWM. Hydrocephalus is also usually (80% of the time) not present at birth in those with DWM. 345:
or infection. The prognosis after successful hydrocephalus treatment is usually good but depends on any associated condition and its symptoms. Those without hydrocephalus are treated based on any associated symptoms or condition.
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The prognosis is first and foremost dependent on the early and successful treatment of hydrocephalus, if present. The other significant factor affecting prognosis is the presence of a comorbid genetic condition or brain anomaly.
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Spennato, Pietro; Mirone, Giuseppe; Nastro, Anna; Buonocore, Maria Consiglio; Ruggiero, Claudio; Trischitta, Vincenzo; Aliberti, Ferdinando; Cinalli, Giuseppe (October 2011). "Hydrocephalus in Dandy-Walker malformation".
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A 2017 review found that most patients (65%) were diagnosed with either "Dandy–Walker malformation" or "Dandy–Walker syndrome", while 20% were diagnosed with "Dandy–Walker variant" and 1.1% with "mega cisterna magna".
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described the malformation as partial or complete absence of the cerebellar vermis, an enlarged fourth ventricle and hydrocephalus. In 1942, American physician John K. Taggart and Canadian–American neurosurgeon
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The precise diagnostic criteria and classification systems of DWM are not agreed upon, and significant dispute exists as to which terms or criteria should be used. The core criteria of DWM are hypoplasia of the
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and circulation. Excisions of the cyst in DWM have not been able to show whether impaired arachnoid absorption is involved, since the subarachnoid space always takes days to weeks to fill up following excision.
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has been found in between 5% and 17% of those with DWM. This does not seem to result in intellectual disability on its own, however. Other brain abnormalities known to be sometimes associated with DWM include
723:, a condition involving neurological and sometimes eye and kidney abnormalities. Anywhere from 21% to 81% of those with PHACE syndrome have DWM. Other comorbid genetic conditions that were found included 1624:
Barkovich, A. J.; Kjos, B. O.; Norman, D.; Edwards, M. S. (December 1989). "Revised classification of posterior fossa cysts and cystlike malformations based on the results of multiplanar MR imaging".
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to allow CSF to bypass any obstruction. It cannot be used on those with brain abnormalities such as agenesis of the corpus callosum, due to the risk of CSF escaping to other brain areas. A compressed
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Blake's pouch cyst (BPC), or persistent Blake's pouch, is a condition that arises when Blake's pouch, an invagination in the fourth ventricle that ruptures at around 4 months of gestation to form the
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scan is the most useful method for diagnosis. MRI can delineate the shape and extent of the malformation as well as assessing additional areas for malformations such as the cerebellar hemispheres,
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used to treat DWM have a moderate-to-good success rate, but they have a higher-than-average failure rate, which can result in failure to reduce the intracranial pressure or infection, such as
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genetic condition, though the causative condition is only identified in around half of those diagnosed before birth and a third of those diagnosed after birth. The mechanism involves impaired
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occasionally occurs with DWM, though it is not certain how often. One review reported an occurrence of 4.3% in a sample. This may be due to herniation of the bottom of the cyst through the
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of the heart. In true DWM, this will find a flow from the cerebral aqueduct to the posterior fossa and no flow between the cisterna magna and the space behind the cervical spinal cord.
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It is known that once hydrocephalus has started, the compression by the posterior fossa cyst against the venous passages in the arachnoid mater is involved in the worsening pathology.
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The prevalence of DWM is estimated at between 1 in 25,000 to 1 in 50,000. DWM is the cause of around 4.3% of cases of congenital hydrocephalus and 2.5% of all cases of hydrocephalus.
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Hammond, Christopher J.; Chitnavis, Bhupal; Penny, Christopher C.; Strong, Anthony J. (2002-01-01). "Dandy-Walker Complex and Syringomyelia in an Adult: Case Report and Discussion".
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Forzano, F.; Mansour, S.; Ierullo, A.; Homfray, T.; Thilaganathan, B. (2007). "Posterior fossa malformation in fetuses: a report of 56 further cases and a review of the literature".
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may occur in DWM. This has generally been found at rates of 6–8%. It has been suggested to occur to compensate for the increased pressure in the posterior fossa during foetal life.
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affecting the long period of development of the cerebellar vermis. The mechanism by which hydrocephalus occurs in DWM is not yet fully understood. The condition is diagnosed by
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Kollias, S. S.; Ball, W. S.; Prenger, E. C. (November 1993). "Cystic malformations of the posterior fossa: differential diagnosis clarified through embryologic analysis".
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and form a scarring adhesion at the cervical junction, preventing it from shrinking again. If this occurs, a suboccipital decompression with duraplasty may be attempted.
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DWM is caused by any disruption to embryonic development that affects the formation of the cerebellar vermis. This is usually a genetic mutation that results in impaired
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Pandurangi, Swapna; Pandurangi, Aditya; Matkar, Abhay; Shetty, Nithin; Patil, Preetam (January 2014). "Psychiatric Manifestations Associated With Mega Cisterna Magna".
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VP shunt), studies have generally found a roughly 50% successful cyst size reduction rate, with successful ventricle size reduction roughly two thirds of the time.
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younger than five years, have been labeled developmental retrocerebellar cysts under a new classification in relation to the proposed neuroendoscopic management.
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Asai, Akio; Hoffman, Harold J.; Hendrick, Bruce; Humphreys, Robin P. (1989). "Dandy-Walker Syndrome: Experience at the Hospital for Sick Children, Toronto".
326:. There are other malformations that can strongly resemble DWM, and disagreement exists around the criteria and classifications used for the malformation. 550:. Slightly more of these were found in Dandy–Walker variant (DWV) than in classic DWM, despite DWV being less common, at only around 20% of DWS diagnoses. 3122:
Pascual-Castroviejo, I.; Velez, A.; Pascual-Pascual, S. I.; Roche, M. C.; Villarejo, F. (1991-04-01). "Dandy-Walker malformation: analysis of 38 cases".
1101:) for a malformation in which the posterior fossa is not enlarged but the cerebellar vermis is hypoplastic. In 1989, Barkovich et al. proposed the term 3517: 3340:
Kaplan, Lawrence C. (1985). "Congenital Dandy Walker malformation associated with first trimester warfarin: A case report and literature review".
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Klein, O.; Pierre-Kahn, A.; Boddaert, N.; Parisot, D.; Brunelle, F. (August 2003). "Dandy-Walker malformation: prenatal diagnosis and prognosis".
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In Dandy–Walker variant (DWV) and mega cisterna magna specifically, which are less severe malformations, there appears to be an increased rate of
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The reason why hydrocephalus occurs in DWM is not yet fully understood. The earliest authors had put it down it to blockage or narrowing of the
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Kumar, Raj; Jain, Manoj; Chhabra, Devendra (2001-05-01). "Dandy-Walker syndrome: different modalities of treatment and outcome in 42 cases".
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A) plus a third malformation (under type B) in which the cerebellar vermis remains large enough to sit between the fourth ventricle and the
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below the fourth ventricle, is enlarged. It has been proposed to be due to a delayed rupture of Blake's pouch rather than a failed rupture.
2520:"The Lateral Recesses of the Fourth Ventricle; Their Relation to Certain Cysts and Tumours of the Cerebellum, and to Occipital Meningocele" 1394:
logical option. However, it is associated with a high rate of complications, including shifting and overdrainage. Overdrainage can lead to
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and brain damage. A minority of those affected do not develop hydrocephalus and are treated based on any associated symptoms or condition.
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The main immediate goal of treatment is the control of hydrocephalus and the enlarged posterior fossa cyst, as these can lead to increased
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In 2011, Spennato et al. came up with a set of criteria based on Klein et al. (2003) that they considered necessary for diagnosis of DWM:
3945: 1732: 1249:(medial aperture), fails to rupture. This can lead to a dilated fourth ventricle and subsequent hydrocephalus of all four ventricles. 1211: 17: 715:
A genetic condition is identified in around 33% of those diagnosed with DWM after birth. In a 2017 review, 4.3% were found to have
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16% of patients were diagnosed with a mental or behavioural disorder, with 6.4% also having a learning disability. 5.3% had either
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A 2017 review found the following associations in patients with DWS (usually from an associated genetic condition or abnormality):
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Bosemani, Thangamadhan; Orman, Gunes; Boltshauser, Eugen; Tekes, Aylin; Huisman, Thierry A. G. M.; Poretti, Andrea (2015-01-01).
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The rest of the cerebellar vermis is hypoplastic and is pushed upwards and rotated forwards due to the enlarged posterior fossa.
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Lumenta, Christianto B.; Skotarczak, Ulrich (1995-03-01). "Long-term follow-up in 233 patients with congenital hydrocephalus".
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Stambolliu, Emelina; Ioakeim-Ioannidou, Myrsini; Kontokostas, Kimonas; Dakoutrou, Maria; Kousoulis, Antonis A. (2017-09-01).
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Azab, Waleed A.; Shohoud, Sherien A.; Elmansoury, Tamer M.; Salaheddin, Waleed; Nasim, Khurram; Parwez, Aslam (2014-07-24).
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Dandy–Walker malformation is diagnosed based on the characteristic neuroimaging findings. It can be diagnosed prenatally on
445:/three lobules in the vermis), and these comprised 16% of their sample. Hydrocephalus also affected all of these patients. 299:
or underdeveloped genitalia or kidneys. It is sometimes discovered in adolescents or adults due to mental health problems.
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Other systemic or genetic conditions are often present with DWM, and each have their own significant effect on prognosis.
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Calabrò, F.; Arcuri, T.; Jinkins, J. R. (2000-04-01). "Blake's pouch cyst: an entity within the Dandy-Walker continuum".
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within the first year of life, which can present as increasing head size, vomiting, excessive sleepiness, irritability,
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Badano JL, Mitsuma N, Beales PL, Katsanis N (2006). "The ciliopathies: an emerging class of human genetic disorders".
1417:(ETV) may be considered as the first-line treatment. This less invasive procedure creates an artificial hole in the 1306:
There is debate as to whether this malformation is distinct from DWM or forms part of the "Dandy–Walker continuum".
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The impairment to CSF flow may lie beyond the outlets of the fourth ventricle. Theories of abnormal development or
655:). Alternatively, it may be a result of hydrocephalus, in which it forms as a "fifth ventricle" due to an enlarged 338: 205: 553:
Around 12% of patients had cancers or tumours arising from congenital genetic abnormalities. The most common were
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5.9% of patients had underdeveloped reproductive organs, such as hypoplastic genitalia or undescended testicles (
413: 292: 119: 3385:"Developmental Retrocerebellar Cysts: A New Classification for Neuroendoscopic Management and Systematic Review" 1273:
Some authors, however, consider Blake's pouch cyst part of a continuum with DWM (the "Dandy–Walker continuum").
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Poetke, M.; Frommeld, T.; Berlien, H. P. (December 2002). "PHACE syndrome: new views on diagnostic criteria".
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Golden, Jeffrey A.; Rorke, Lucy B.; Bruce, Derek A. (1987). "Dandy-Walker Syndrome and Associated Anomalies".
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Taggart, John K.; Walker, A. Earl (1942-10-01). "Congenital Atresia of the Foramens of Luschka and Magendie".
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DWM has a large number of conditions that can present highly similarly on imaging and confound diagnosis.
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Bindal, Ajay K.; Storrs, Bruce B.; McLone, David G. (1990). "Management of the Dandy-Walker Syndrome".
788: 752: 736: 1831:"The Most Common Comorbidities in Dandy-Walker Syndrome Patients: A Systematic Review of Case Reports" 3755: 1195: 1057:. It is diagnosed within the first year of life 41% of the time, normally due to increasing signs of 871: 792: 756: 732: 493: 442: 399:. In contrast to classic DWM, only around 30% of those with Dandy–Walker variant (DWV), in which the 2786:
Bindal, A. K.; Storrs, B. B.; McLone, D. G. (1990–1991). "Management of the Dandy-Walker syndrome".
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The cyst is clearly localised in a specific location separate from the fourth ventricle outlets.
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The cerebellum is not hypoplastic, though it may be compressed by the enlarged posterior fossa (
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Hydrocephalus, if it occurs, is due to the cyst pressing on the cerebellum and compressing the
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begins forming at the fifth week of embryonic development. It differentiates at the top of the
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9% of patients (almost all with classic DWM) had musculoskeletal abnormalities, which included
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detailed the phenomenon extensively, ascribing the potential cause as underdevelopment of the
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Metry DW, Dowd CF, Barkovich AJ, Frieden IJ (July 2001). "The many faces of PHACE syndrome".
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The cerebellum is not hypoplastic, though it may be compressed by the cyst (mass effect).
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has also been described in a handful of cases. Many of these disorders are classified as
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In DWM, the fourth ventricle opens up into and is continuous with almost the entire
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The angle at the centre of the cerebellar vermis (representing the location of the
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as early as 14 weeks of gestation, although it is usually diagnosed postnatally by
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Hydrocephalus: increasing head size, vomiting, excessive sleepiness, irritability,
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has been found with DWM. When it is present, it is usually spina bifida occulta.
392: 2562:"AN EXPERIMENTAL, CLINICAL AND PATHOLOGICAL STUDY: Part 1.—Experimental Studies" 941:
Diagram of the cerebellum, fourth ventricle and pons. The white arrow shows the
823:. DWM is one of the single largest predictors of a ciliopathic genetic disease. 333:
in infancy. This is usually inserted in the posterior fossa, but a shunt in the
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is absent to varying degrees (three quarters, one half or one quarter missing).
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Dandy–Walker syndrome (DWS), Dandy–Walker complex (DWC), Dandy–Walker continuum
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The CSF flow in the cyst is not continuous with that of the fourth ventricle.
1066: 1058: 1016: 962: 926: 816: 808: 698: 656: 644: 638: 516: 501: 453: 426: 387: 315: 296: 272: 247:), is a rare congenital brain malformation in which the part joining the two 3353: 3121: 2987: 2535: 1572:"The Dandy-Walker Syndrome or The So-Called Atresia of the Foramen Magendie" 3884: 3879: 3827: 3745: 3717: 3455: 3408: 3318: 3275: 3100: 3038: 2995: 2909: 2858: 2772: 2721: 2410: 2269: 2211: 2133: 2070: 1865: 1705: 1637: 1605: 1588: 1528:
The term Dandy–Walker syndrome (DWS) was introduced by German psychiatrist
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in the posterior fossa have been put forward. The arachnoid mater contains
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The most frequent and prominent symptoms of DWM are those associated with
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American Journal of Medical Genetics Part C: Seminars in Medical Genetics
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An arachnoid cyst is a collection of cerebrospinal fluid (CSF) in the
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malformation. The malformation was first described by English surgeon
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and partial 3q deletion or duplication. The 3q24 region contains the
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are pushed forwards and to the side by the enlarged posterior fossa.
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24% of patients had at least one ocular abnormality. These included
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sleepiness, irritability, downward deviation of the eyes (known as "
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Blake's pouch cyst (BPC), mega cisterna magna(?), posterior fossa
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In DWM, it is not agreed whether a shunt should be placed in the
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Craniosynostosis-Dandy-Walker malformation-hydrocephalus syndrome
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The malformation was first described in 1887 by English surgeon
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The cerebellar tentorium/confluence of sinuses is not raised.
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15% risk of death, mostly from hydrocephalus or its treatment
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Hydrocephalus, when it occurs, involves all four ventricles.
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necessary to return CSF from the subarachnoid spaces to the
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Imataka, George; Yamanouchi, Hideo; Arisaka, Osamu (2007).
2879: 966: 858: 828: 686: 547: 68: 3242:"Making sense of cilia in disease: The human ciliopathies" 1623: 937: 633:
5.3% of patients had underdeveloped or polycystic kidneys.
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The Journal of Neuropsychiatry and Clinical Neurosciences
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can observe the flow of cerebrospinal fluid (CSF) during
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that are believed to be crucial in signalling embryonic
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National Institute of Neurological Disorders and Stroke
2785: 1141:(the space behind the cerebellum) is enlarged, and its 1008:, the two apertures in the fourth ventricle that allow 743:, among many others. DWM has also been associated with 1576:
Journal of Neuropathology & Experimental Neurology
3217:"OMIM Entry - # 200990 - ACROCALLOSAL SYNDROME; ACLS" 3067:"Dandy–Walker syndrome and chromosomal abnormalities" 3008: 2560:
Dandy, Walter E.; Blackfan, Kenneth D. (1914-12-01).
1145:
flow is continuous with that of the fourth ventricle.
585:
that lead to the DWM, since the subsequent embryonic
3528: 1675: 1327:
In a posterior fossa arachnoid cyst, unlike in DWM:
870:
In those who are diagnosed with DWM before birth on
354:
in 1887, though it was named by German psychiatrist
67:
of Dandy–Walker variant (DWV) with dysplasia of the
1410:should be considered before installing a VP shunt. 1299:
The fourth ventricle is of relatively normal shape.
995: 373:, who described it in 1914 and 1942, respectively. 2645: 2293: 329:Treatment for most involves the implantation of a 144:Dandy–Walker variant (DWV), mega cisterna magna(?) 2463: 2236:"Congenital Abnormalities of the Posterior Fossa" 1402:, due to scarring, or downward herniation of the 1309: 1093:In 1976, Harwood-Nash and Fitz proposed the term 826:Other genes that have been linked to DWM include 704: 3927: 3429: 2930: 2691: 2687: 2685: 1281:Mega cisterna magna is a condition in which the 1118:. In 1999, Calabró et al. first used the phrase 27:Congenital malformation of the cerebellar vermis 3382: 2442:NORD (National Organization for Rare Disorders) 1365:For hydrocephalus or the posterior fossa cyst, 1182:vermis to touch the tentorium or an absence of 913:use during pregnancy has been known to lead to 604:disorders, and 2.7% had excessive hair growth ( 2343:"Orphanet: Isolated Dandy Walker malformation" 1072: 118:, eye abnormalities, intellectual disability, 3655: 3423: 2967: 2682: 2601: 2559: 1324:. 10% of these occur in the posterior fossa. 1198:as early as 14 weeks of gestation, though an 807:, genetic disorders that affect the cellular 1525:, now no longer believed to be significant. 1381:(a cystoperitoneal shunt, or CP shunt), the 865: 3239: 3662: 3648: 3290: 1460:. Complications from overdrainage such as 1296:The cerebellum is not usually hypoplastic. 90: 51: 3257: 3082: 2251: 2201: 2183: 1587: 1232: 2616:10.1001/archneurpsyc.1942.02290100083008 2566:American Journal of Diseases of Children 1252:In a Blake's pouch cyst, unlike in DWM: 982:particularly vulnerable to disruptions. 936: 902:genes, known to be associated with DWM. 673: 159:genetic conditions, often not identified 132:Shunt failure (shifting, overdrainage), 3847:Bilateral frontoparietal polymicrogyria 3509:in the Journal of Pediatrics, July 2001 3240:Baker, Kate; Beales, Philip L. (2009). 1292:In mega cisterna magna, unlike in DWM: 681:(E) location shown in red, between the 471: 337:may be used instead or in conjunction. 295:, skeletal abnormalities, an occipital 14: 3951:Syndromes affecting the nervous system 3936:Congenital disorders of nervous system 3928: 3487:Dandy-Walker Syndrome Information Page 3339: 3060: 3058: 3056: 2604:Archives of Neurology & Psychiatry 2517: 2513: 2511: 2459: 2457: 2432: 2430: 2428: 1626:AJR. American Journal of Roentgenology 1276: 953:(3). This usually remains open in DWM. 929:. In 1985, it was also linked to DWM. 773:Fukuyama congenital muscular dystrophy 3643: 3520:from Pan Arab Journal of Neurosurgery 3383:Dhandapani, S; Sahoo, SK (Dec 2019). 3311:10.1146/annurev.genom.7.080505.115610 3011:European Journal of Pediatric Surgery 2641: 2639: 2637: 2635: 2633: 2597: 2595: 2555: 2553: 2376: 2374: 2372: 2370: 2368: 2366: 2364: 2362: 2337: 2335: 2333: 2289: 2287: 2285: 2283: 2281: 2279: 2229: 2227: 2225: 2223: 2221: 2161: 2159: 2157: 2155: 2153: 2151: 2098: 2096: 2094: 2092: 2090: 2088: 2035: 2033: 2031: 2029: 2027: 2025: 2023: 2021: 2019: 2017: 2015: 2013: 2011: 2009: 2007: 2005: 2003: 2001: 1999: 1997: 1995: 1993: 1991: 1989: 1987: 1985: 1983: 1981: 1979: 1977: 1975: 1973: 1971: 1969: 1967: 1965: 1963: 1961: 1959: 1957: 1955: 1953: 1951: 1949: 1947: 1945: 1943: 1941: 1939: 1937: 1935: 1933: 1931: 1929: 1927: 1925: 1923: 1921: 1919: 1917: 1915: 1913: 1911: 1909: 1907: 1905: 1903: 1824: 1822: 1820: 1818: 1816: 1814: 1812: 1810: 1808: 1806: 1804: 1802: 1800: 1798: 1796: 1794: 1792: 1790: 1788: 1786: 1784: 1782: 1780: 1778: 1776: 1774: 1772: 1727: 1725: 1723: 1671: 1669: 1667: 1665: 1663: 1569: 1565: 1563: 1561: 1360: 1240: 403:is not enlarged, have hydrocephalus. 376: 365:in 1954 after American neurosurgeons 263:and space behind the cerebellum (the 2578:10.1001/archpedi.1914.02180010416002 1901: 1899: 1897: 1895: 1893: 1891: 1889: 1887: 1885: 1883: 1770: 1768: 1766: 1764: 1762: 1760: 1758: 1756: 1754: 1752: 1619: 1617: 1615: 1263:The posterior fossa is not enlarged. 1123:However, they remain commonly used. 3430:Yüceer N, Mertol T, Arda N (2007). 3053: 2508: 2454: 2425: 2106:Journal of Neurosurgery. Pediatrics 24: 3946:Syndromes affecting the cerebellum 3673:malformations and deformations of 3498: 3233: 2630: 2592: 2550: 2359: 2330: 2308:10.1148/radiographics.13.6.8031352 2276: 2218: 2148: 2085: 1720: 1660: 1558: 1194:DWM can be observed prenatally on 932: 905: 811:, thin cell projections made from 25: 3962: 3524: 3518:Dandy–Walker Malformation article 1880: 1749: 1612: 1504:. In 1914, American neurosurgeon 1413:In patients older than one year, 945:(medial aperture) connecting the 874:, up to half are found to have a 271:. Most of those affected develop 3479: This article incorporates 3474: 3084:10.1111/j.1741-4520.2007.00158.x 2894:10.1097/00006123-200201000-00028 2757:10.1176/appi.neuropsych.13040097 2172:Surgical Neurology International 1570:Benda, Clemens E. (1954-01-01). 1415:endoscopic third ventriculostomy 996:Pathophysiology of hydrocephalus 381: 339:Endoscopic third ventriculostomy 206:endoscopic third ventriculostomy 3799:Agenesis of the corpus callosum 3376: 3333: 3209: 3166: 3115: 3002: 2924: 2873: 2822: 2779: 2736: 2518:Sutton, J. Bland (1886-10-01). 1539:in 1954; he also used the term 1471: 923:agenesis of the corpus callosum 917:, including ocular dysgenesis, 414:Agenesis of the corpus callosum 406: 293:agenesis of the corpus callosum 259:) does not fully form, and the 120:agenesis of the corpus callosum 114:Associated genetic conditions: 1310:Posterior fossa arachnoid cyst 725:oculocerebrocutaneous syndrome 705:Ciliopathic genetic conditions 277:downward deviation of the eyes 204:, ventriculoperitoneal shunt, 122:, skeletal abnormalities, etc. 13: 1: 3513:E-medicine webpage definition 1551: 925:, skeletal abnormalities and 915:systemic defects in the fetus 878:, with the most common being 569:(4.4%). 3.2% of patients had 535:(a hole in an eye structure). 425:(fewer ridges in the brain), 1446: 1348: 1344:or fourth ventricle outlets. 1044: 729:oral-facial-digital syndrome 561:(4.8%, including those with 450:psychotic spectrum disorders 7: 3765:other reduction deformities 2438:"Dandy Walker Malformation" 1508:and American paediatrician 1073:Criteria and classification 571:congenital melanocytic nevi 544:psychotic spectrum disorder 523:dysplasia/atrophy, a small 302:DWM is usually caused by a 10: 3967: 3401:10.1016/j.wneu.2019.08.052 1838:Journal of Child Neurology 1483: 1313: 1302:Hydrocephalus is uncommon. 1189: 789:Cornelia de Lange syndrome 777:Ellis–Van Creveld syndrome 708: 226:1 in 25,000 to 1 in 50,000 3893: 3870: 3861: 3738: 3690: 3681: 3613: 3532: 2395:10.1007/s00381-003-0782-5 2055:10.1007/s00381-011-1544-4 1541:Dandy–Walker malformation 1130:The lower portion of the 866:Chromosomal abnormalities 761:Shah–Waardenburg syndrome 749:Rubinstein–Taybi syndrome 494:ventricular septal defect 233:Dandy–Walker malformation 222: 212: 196: 183: 163: 148: 140: 126: 99: 79: 59: 50: 42: 38:Dandy–Walker malformation 37: 3751:Congenital hydrocephalus 3299:Annu Rev Genom Hum Genet 2185:10.4103/2152-7806.137533 2118:10.3171/PED/2008/2/9/194 1850:10.1177/0883073817712589 1437: 669: 651:(a similar mechanism to 555:neurocutaneous melanosis 490:coarctation of the aorta 486:patent ductus arteriosus 289:congenital heart defects 116:congenital heart defects 3354:10.1002/tera.1420320302 2988:10.1067/mpd.2001.114880 876:chromosomal abnormality 769:Walker–Warburg syndrome 500:. In 2.7% of patients, 482:congenital heart defect 419:grey matter heterotopia 3481:public domain material 3175:Pediatric Neurosurgery 3124:Child's Nervous System 2933:Pediatric Neurosurgery 2788:Pediatric Neurosurgery 2694:Child's Nervous System 2648:Pediatric Neurosurgery 2466:Child's Nervous System 2383:Child's Nervous System 2043:Child's Nervous System 1638:10.2214/ajr.153.6.1289 1233:Differential diagnosis 1153:cerebellar hemispheres 1120:Dandy–Walker continuum 975:cerebellar hemispheres 954: 753:Marden–Walker syndrome 737:Meckel–Gruber syndrome 690: 573:, and 2.1% had tongue 480:27% of patients had a 185:Differential diagnosis 3804:Septo-optic dysplasia 3756:Dandy–Walker syndrome 2706:10.1007/s003810000425 2536:10.1093/brain/9.3.352 1690:10.1007/s002340050888 1492:as hypoplasia of the 1355:intracranial pressure 1167:confluence of sinuses 1114:classified as simply 940: 797:acrocallosal syndrome 793:Klippel–Feil syndrome 757:Sheldon–Hall syndrome 733:Coffin–Siris syndrome 677: 241:Dandy–Walker syndrome 18:Dandy–Walker syndrome 3506:Metry Phaces article 3259:10.1002/ajmg.c.30231 3071:Congenital Anomalies 3023:10.1055/s-2002-36849 2253:10.1148/rg.351140038 2168:"Blake's pouch cyst" 1589:10.1093/jnen/13.1.14 1404:cerebral hemispheres 1400:tethered spinal cord 1287:subarachnoid cistern 1175:cerebellar tentorium 1103:Dandy–Walker complex 1095:Dandy–Walker variant 1002:foramina of Magendie 596:10% of patients had 593:, among other cells. 498:atrial septal defect 472:Associated anomalies 429:(shallower ridges), 267:) are enlarged with 3730:Chiari malformation 1530:Clemens Ernst Benda 1519:foramina of Luschka 1462:subdural haematomas 1396:subdural haematomas 1277:Mega cisterna magna 1247:foramen of Magendie 1143:cerebrospinal fluid 1116:mega–cisterna magna 1036:Aqueductal stenosis 1010:cerebrospinal fluid 943:foramen of Magendie 653:Chiari malformation 519:dysplasia/atrophy, 356:Clemens Ernst Benda 343:subdural haematomas 324:prenatal ultrasound 322:or, less commonly, 269:cerebrospinal fluid 174:prenatal ultrasound 107:vertical gaze palsy 3901:Currarino syndrome 3872:Neural tube defect 3814:Hemimegalencephaly 3780:Microlissencephaly 3692:Neural tube defect 3614:External resources 3136:10.1007/BF00247863 2831:Prenatal Diagnosis 2478:10.1007/BF00570260 1515:Arthur Earl Walker 1383:lateral ventricles 1370:herniate into the 1361:Hydrocephalus/cyst 1241:Blake's pouch cyst 1212:phase-contrast MRI 1177:is also elevated.) 990:subarachnoid space 955: 691: 377:Signs and symptoms 371:Arthur Earl Walker 335:lateral ventricles 285:genetic conditions 134:subdural haematoma 3923: 3922: 3919: 3918: 3857: 3856: 3770:Holoprosencephaly 3637: 3636: 3448:10.1159/000106383 3436:Pediatr Neurosurg 3187:10.1159/000120445 2945:10.1159/000120299 2800:10.1159/000120518 2660:10.1159/000120518 2049:(10): 1665–1681. 1737:www.ninds.nih.gov 1494:cerebellar vermis 1490:John Bland-Sutton 1387:cerebral aqueduct 1342:cerebral aqueduct 1204:cerebral aqueduct 1160:fastigial nucleus 1132:cerebellar vermis 1080:cerebellar vermis 741:Kallmann syndrome 581:of the embryonic 484:. These included 435:holoprosencephaly 352:John Bland-Sutton 257:cerebellar vermis 239:), also known as 230: 229: 165:Diagnostic method 73:cerebellar vermis 32:Medical condition 16:(Redirected from 3958: 3906:Diastomatomyelia 3868: 3867: 3688: 3687: 3664: 3657: 3650: 3641: 3640: 3530: 3529: 3495: 3478: 3477: 3468: 3467: 3427: 3421: 3420: 3380: 3374: 3373: 3337: 3331: 3330: 3294: 3288: 3287: 3261: 3237: 3231: 3230: 3228: 3227: 3213: 3207: 3206: 3170: 3164: 3163: 3119: 3113: 3112: 3086: 3062: 3051: 3050: 3006: 3000: 2999: 2971: 2965: 2964: 2928: 2922: 2921: 2877: 2871: 2870: 2826: 2820: 2819: 2783: 2777: 2776: 2740: 2734: 2733: 2689: 2680: 2679: 2643: 2628: 2627: 2599: 2590: 2589: 2557: 2548: 2547: 2515: 2506: 2505: 2461: 2452: 2451: 2449: 2448: 2434: 2423: 2422: 2389:(7–8): 484–489. 2378: 2357: 2356: 2354: 2353: 2339: 2328: 2327: 2302:(6): 1211–1231. 2291: 2274: 2273: 2255: 2231: 2216: 2215: 2205: 2187: 2163: 2146: 2145: 2100: 2083: 2082: 2037: 1878: 1877: 1835: 1826: 1747: 1746: 1744: 1743: 1729: 1718: 1717: 1673: 1658: 1657: 1632:(6): 1289–1300. 1621: 1610: 1609: 1591: 1567: 1538: 1510:Kenneth Blackfan 1379:fourth ventricle 1210:. Cardiac-gated 1084:fourth ventricle 1082:and an enlarged 971:fourth ventricle 947:fourth ventricle 880:Edwards syndrome 799:, among others. 785:Aicardi syndrome 721:Joubert syndrome 679:Fourth ventricle 540:bipolar disorder 458:bipolar disorder 364: 287:and can include 261:fourth ventricle 200:Cystoperitoneal 95: 94: 86:Medical genetics 75:in an 8-year old 55: 35: 34: 21: 3966: 3965: 3961: 3960: 3959: 3957: 3956: 3955: 3926: 3925: 3924: 3915: 3889: 3853: 3790:Hydranencephaly 3734: 3677: 3668: 3638: 3633: 3632: 3609: 3608: 3541: 3527: 3501: 3499:Further reading 3484: 3475: 3472: 3471: 3428: 3424: 3389:World Neurosurg 3381: 3377: 3338: 3334: 3295: 3291: 3238: 3234: 3225: 3223: 3215: 3214: 3210: 3171: 3167: 3120: 3116: 3063: 3054: 3007: 3003: 2972: 2968: 2929: 2925: 2878: 2874: 2843:10.1002/pd.1722 2827: 2823: 2784: 2780: 2741: 2737: 2690: 2683: 2644: 2631: 2600: 2593: 2558: 2551: 2516: 2509: 2462: 2455: 2446: 2444: 2436: 2435: 2426: 2379: 2360: 2351: 2349: 2341: 2340: 2331: 2292: 2277: 2232: 2219: 2164: 2149: 2101: 2086: 2038: 1881: 1844:(10): 886–902. 1833: 1827: 1750: 1741: 1739: 1731: 1730: 1721: 1674: 1661: 1622: 1613: 1568: 1559: 1554: 1532: 1498:posterior fossa 1486: 1474: 1449: 1440: 1419:third ventricle 1363: 1351: 1322:arachnoid mater 1318: 1312: 1279: 1243: 1235: 1208:corpus callosum 1192: 1186:abnormalities. 1139:posterior fossa 1088:posterior fossa 1075: 1047: 1021:arachnoid mater 998: 987:posterior fossa 935: 933:Pathophysiology 908: 906:External toxins 868: 781:Fraser syndrome 713: 707: 672: 546:, and 2.1% had 474: 409: 401:posterior fossa 393:sunsetting eyes 384: 379: 358: 265:posterior fossa 113: 89: 33: 28: 23: 22: 15: 12: 11: 5: 3964: 3954: 3953: 3948: 3943: 3941:Rare syndromes 3938: 3921: 3920: 3917: 3916: 3914: 3913: 3908: 3903: 3897: 3895: 3891: 3890: 3888: 3887: 3882: 3876: 3874: 3865: 3859: 3858: 3855: 3854: 3852: 3851: 3850: 3849: 3842:Polymicrogyria 3838: 3837: 3836: 3835: 3833:Schizencephaly 3830: 3817: 3816: 3811: 3809:Megalencephaly 3806: 3801: 3795: 3794: 3793: 3792: 3787: 3782: 3777: 3772: 3761: 3760: 3759: 3758: 3748: 3742: 3740: 3736: 3735: 3733: 3732: 3727: 3722: 3721: 3720: 3715: 3710: 3705: 3696: 3694: 3685: 3679: 3678: 3675:nervous system 3667: 3666: 3659: 3652: 3644: 3635: 3634: 3631: 3630: 3618: 3617: 3615: 3611: 3610: 3607: 3606: 3595: 3584: 3573: 3558: 3542: 3537: 3536: 3534: 3533:Classification 3526: 3525:External links 3523: 3522: 3521: 3515: 3510: 3500: 3497: 3470: 3469: 3422: 3375: 3348:(3): 333–337. 3332: 3289: 3252:(4): 281–295. 3232: 3208: 3165: 3114: 3077:(4): 113–118. 3052: 3017:(6): 366–374. 3001: 2966: 2923: 2888:(1): 191–194. 2872: 2837:(6): 495–501. 2821: 2794:(3): 163–169. 2778: 2751:(2): 169–171. 2735: 2700:(6): 348–352. 2681: 2654:(3): 163–169. 2629: 2610:(4): 583–612. 2591: 2572:(6): 406–482. 2549: 2530:(3): 352–361. 2507: 2472:(3): 173–175. 2453: 2424: 2358: 2329: 2275: 2246:(1): 200–220. 2217: 2147: 2112:(3): 194–199. 2084: 1879: 1748: 1719: 1684:(4): 290–295. 1678:Neuroradiology 1659: 1611: 1556: 1555: 1553: 1550: 1546:cisterna magna 1496:, an enlarged 1485: 1482: 1473: 1470: 1448: 1445: 1439: 1436: 1372:foramen magnum 1362: 1359: 1350: 1347: 1346: 1345: 1338: 1335: 1332: 1316:Arachnoid cyst 1314:Main article: 1311: 1308: 1304: 1303: 1300: 1297: 1283:cisterna magna 1278: 1275: 1271: 1270: 1267: 1264: 1261: 1242: 1239: 1234: 1231: 1191: 1188: 1179: 1178: 1171:occipital lobe 1163: 1156: 1149: 1146: 1135: 1111:cisterna magna 1074: 1071: 1046: 1043: 997: 994: 977:form from the 951:cisterna magna 934: 931: 907: 904: 890:(trisomy 13), 888:Patau syndrome 867: 864: 765:Fryns syndrome 717:PHACE syndrome 709:Main article: 706: 703: 695:cell migration 671: 668: 649:foramen magnum 635: 634: 631: 628:cryptorchidism 624: 621:arthrogryposis 617:kyphoscoliosis 609: 606:hypertrichosis 594: 589:gives rise to 563:PHACE syndrome 551: 536: 513:microphthalmia 511:, small eyes ( 505: 473: 470: 439:schizencephaly 431:polymicrogyria 408: 405: 383: 380: 378: 375: 331:cerebral shunt 312:cell migration 228: 227: 224: 220: 219: 216: 210: 209: 198: 194: 193: 191:arachnoid cyst 187: 181: 180: 167: 161: 160: 150: 146: 145: 142: 138: 137: 130: 124: 123: 103: 97: 96: 83: 77: 76: 57: 56: 48: 47: 44: 40: 39: 31: 26: 9: 6: 4: 3: 2: 3963: 3952: 3949: 3947: 3944: 3942: 3939: 3937: 3934: 3933: 3931: 3912: 3911:Syringomyelia 3909: 3907: 3904: 3902: 3899: 3898: 3896: 3892: 3886: 3883: 3881: 3878: 3877: 3875: 3873: 3869: 3866: 3864: 3860: 3848: 3845: 3844: 3843: 3840: 3839: 3834: 3831: 3829: 3826: 3825: 3824: 3823: 3819: 3818: 3815: 3812: 3810: 3807: 3805: 3802: 3800: 3797: 3796: 3791: 3788: 3786: 3783: 3781: 3778: 3776: 3775:Lissencephaly 3773: 3771: 3768: 3767: 3766: 3763: 3762: 3757: 3754: 3753: 3752: 3749: 3747: 3744: 3743: 3741: 3737: 3731: 3728: 3726: 3725:Encephalocele 3723: 3719: 3716: 3714: 3711: 3709: 3706: 3703: 3702: 3701: 3698: 3697: 3695: 3693: 3689: 3686: 3684: 3680: 3676: 3672: 3665: 3660: 3658: 3653: 3651: 3646: 3645: 3642: 3629: 3625: 3624: 3620: 3619: 3616: 3612: 3605: 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Index

Dandy–Walker syndrome

T2-weighted
MRI
pons
cerebellar vermis
Specialty
Medical genetics
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Symptoms
vertical gaze palsy
seizures
congenital heart defects
agenesis of the corpus callosum
Complications
subdural haematoma
Ciliopathic
chromosomal
Diagnostic method
MRI
prenatal ultrasound
CT
Differential diagnosis
arachnoid cyst
shunt
endoscopic third ventriculostomy
Prognosis
hemispheres
cerebellum
cerebellar vermis

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