Hydrodynamic factors in Dandy-Walker and Arnold-Chiari malformations.

The Dandy-Walker malformation (DWM) is hydrocephalus that primarily affects the fourth ventricle, whose overdistention involves also the aqueduct and third ventricle. However, just the opposite is true in the Arnold-Chiari malformation (ACM) since the hydrocephalus is limited to the lateral ventricles which squeeze the third ventricle between them and compress the aqueduct and fourth ventricle. The evidence indicates that both result from hydrodynamic stresses in embryonal and early fetal life. This communication is offered in rebuttal to some statements in an otherwise authoritative and comprehensive article.