Dong Zhi-Qiang, Jia Yan-Fei, Gao Zhen-Shan, Li Qiao, Niu Liang, Yang Qiang, Pan Ya-Wen, Li Qiang
Department of Neurosurgery, The Second Hospital of Lanzhou University, Lanzhou 730030, Gansu Province, China.
World J Clin Cases. 2022 Mar 6;10(7):2275-2280. doi: 10.12998/wjcc.v10.i7.2275.
Dandy-Walker malformation (DWM) was first reported in 1914. In this case report, a pediatric case was complicated with giant and isolated arachnoid cysts in the right cerebellar hemisphere along with the typical DWM.
The patient was at 20 mo old boy, with the complaint of staggering for more than 2 mo. He was admitted to the hospital due to high intracranial pressure and staggering. At admission, the patient had typical manifestations of high intracranial pressure, including vomiting, poor appetite and feeding difficulty. Physical examination revealed increased head circumference, closed anterior fontanelle, unstable standing, staggering, leaning right while walking and ataxia. After admission, he was diagnosed with DWM accompanied by giant isolated arachnoid cysts in the posterior fossa. He underwent Y-shaped three-way valve repair for treating differential pressure between the supratentorial hydrocephalus and the subtentorial arachnoid cysts at once. The child recovered well after the surgery.
In this case, supratentorial and subtentorial shunts were placed, which solved the problem of differential pressure between the supratentorial and subtentorial parts simultaneously. This provides useful information regarding treatment exploration in this rare disease.
丹迪-沃克畸形（DWM）于1914年首次被报道。在本病例报告中，一名儿科患者除典型的丹迪-沃克畸形外，还合并右侧小脑半球巨大孤立性蛛网膜囊肿。
该患者为一名20个月大的男孩，主诉蹒跚步态超过2个月。因颅内压增高和蹒跚步态入院。入院时，患者有典型的颅内压增高表现，包括呕吐、食欲差和喂养困难。体格检查发现头围增大、前囟闭合、站立不稳、蹒跚步态、行走时向右倾斜和共济失调。入院后，诊断为丹迪-沃克畸形伴后颅窝巨大孤立性蛛网膜囊肿。他接受了Y形三通瓣膜修复术，一次性治疗幕上脑积水和幕下蛛网膜囊肿之间的压差。术后患儿恢复良好。
在本病例中，同时进行了幕上和幕下分流，解决了幕上和幕下部分之间的压差问题。这为这种罕见疾病的治疗探索提供了有用信息。
