Staged Neuroendoscopic Management of a Dandy Walker Malformation Case Presenting with Complex Hydrocephalus

Authors

  • Marios Theologou Second Department of Neurosurgery, Aristotle University of Thessaloniki, Hippokratio General Hospital of Thessaloniki, Greece https://orcid.org/0000-0002-6580-5382
  • Panagiotis Varoutis Second Department of Neurosurgery, Aristotle University of Thessaloniki, General Hospital of Thessaloniki Hippokratio, Thessaloniki, Greece
  • Vassilios Tsitouras Second Department of Neurosurgery, Aristotle University of Thessaloniki, General Hospital of Thessaloniki Hippokratio, Thessaloniki, Greece

DOI:

https://doi.org/10.31157/an.v29i2.628

Keywords:

Ventriculoperitoneal shunt valves, Hydrocephalus, endoscopic, Lushka and Magendie foraminoplasty, tentorium fenestration

Abstract

Backgroud: Dandy-Walker malformation is a rare congenital condition characterized by alteration of posterior fossa anatomy. Hydrocephalus is a common finding in these patients. VP-shunt placement remains the treatment of choice. Endoscopic Third Ventriculostomy (ETV) is an acceptable alternative for older children. Other techniques have also been proposed.

Case presentation: A full-term infant presented with signs of hydrocephalus. An endoscopic foraminoplasty of the posterior fossa cyst was conducted as a first stage. The cyst’s volume was reduced, without any changes of the supratentorial ventricular dimensions. A month post-surgery signs of hydrocephalus reoccurred. An ETV was performed alongside a fenestration of the tentorium. The toddler was discharged in good condition with amelioration of her symptoms. One month later she presented with recurrent hydrocephalus and subdural hygromas. A shunt was placed in the posterior fossa under endoscopic guidance, and an additional one was introduced in the subdural space. The patient was followed-up for 18 months without any further need for treatment. VP-shunt placement is the treatment of choice.

Discussion: Lushka and Magendie foraminoplasty seems to be ineffective. ETV should be reserved for older children. The ventriculoscope can be employed for positioning the VP-shunt in a specific anatomical region. Subdural hygromas may present after neuroendoscopic treatment. A staged approach may be mandatory for complex hydrocephalus treatment.

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Published

2023-06-22

How to Cite

Theologou, M., Varoutis, P., & Tsitouras, V. (2023). Staged Neuroendoscopic Management of a Dandy Walker Malformation Case Presenting with Complex Hydrocephalus. Archivos De Neurociencias, 29(2). https://doi.org/10.31157/an.v29i2.628

Issue

Vol. 29 No. 2 (2024)

Section

Case report

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Copyright (c) 2022 Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez

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September 2022-present © Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez. Open access articles under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) license, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. No commercial re-use is allowed.

January-September 2022 © The authors. Open access articles under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) license, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. No commercial re-use is allowed.

January 2014-December 2021 © Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez. Open access articles under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) license, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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