ASYMPTOMATIC DANDY WALKER

VARIANT IN ADULT
Sri Noviyanty Yusuf*, Nia Elisa Ginting*, Yusril**, Henry Sugiharto**
*Resident, Neurology Departement, Medical Faculty of Sriwijaya University/Dr. Moh. Hoesin Hospital, Palembang
**Staff,, Neurology Departement, Medical Faculty of Sriwijaya University/Dr. Moh. Hoesin Hospital, Palembang

Introduction Case Report

Dandy-Walker Malformation is a rare congenital
malformation which is characterized by the agenesis or
hypoplasia of vermis cerebellum, cyst dilation of 4th
ventricle and enlargement of posterior fossa. The
incidence of Dandy-Walker Malformation (DWM) in
USA is one case over 25.000-35.000 in every birth rate,
with 40% of them are females and 60% are males.
Meanwhile, there is still no definite incidence of Dandy-
Walker Malformation in Indonesia. There are 11 articles
reported asymptomatic DWM.
A 23 years old female presented with moderate and persistent headache, with no aura or
hallucination since 1 year before admission. There were no symptoms of increased intrakranial
pressure. There is no history head trauma and no history of developmental disorders while
childhood. The neurological physical examination, fundus photos, OCT and humphrey from the eye
part within normal limits. The EEG shows a normal EEG. The head CT-Scan and head MRI of the
contras that revealed agenesis of cerebellar vermis and extensive CSF cysts at the cysterna magna
with the enlarged fourth ventricle suggestive of Dandy-Walker malformation with hydrocephalus. In
these patients managed conservative therapy and follow-up were carried out without surgical
therapy. It seems that in the case of patients with asymptomatic DWS, CSF dynamics compensate for
malformations.

A B
Conclusion
There are important aspects should be followed up in
C asymptomatic Dandy Walker Malformation patients,
there are head MRI to determine the present of
hydrocephalus, high ICP signs, and cerebellum
symptoms examination.

Key Words
Asymptomatic Dandy-Walker Malformation,
A. Sagital T1-weighted Head MRI B. Axial Head MRI showed large C. Coronal Head MRI demostrating Hydrocephalus, Conservative Therapy
showed fluid collection in the posterior fossa cysts with a patent expanded posterior fossa and
posterior fossa which exert right aqueduct vermis cerebella hypoplasia
and left cerebellum with elarged
fourth ventricel and scalloping of
occipital bone
Referensi
1. Medicine P. Dandy-Walker Syndrome: A Case of Conservative Management. 2016. 2(4). 2-4.
2. Jha VC, Kumar R, Sahu RN. A Case series of 12 patients with incidental asymptomatic Dandy-Walker Syndrome and management 2012. 861-867.
https://doi.org/10.1007/s00381-012-1734-8.