Magnetic resonance imaging of an adult with the Dandy-Walker syndrome.

A 30-year-old retired veteran was asymptomatic for two decades; he had carried out normal everyday living activities and was self-supporting. It was not until he was struck by an automobile, which resulted in head trauma, that the Dandy-Walker syndrome was incidentally discovered by computed tomography. Most patients with the Dandy-Walker syndrome or malformation are infants and seldom live into adulthood. Therefore, this patient is one of the very few patients with this malformation who remained in a state of cerebrospinal fluid compensation and lived to adulthood.The head trauma he received in the accident is believed to have activated neurological deficits, visual impairment, and diplopia. Although magnetic resonance imaging revealed severe hydrocephalus and lobar holoprosencephaly, the patient had no symptoms of increased intracranial pressure and no craniofacial deformities except for macrocephaly, and was capable of performing everyday living activities adequately.