Most neurologists and neurosurgeons encounter Dandy-Walker malformation (DWM) at some point during their employment. The cerebellar vermis is characterized by partial or full dysgenesis. The range of outcomes is wide, ranging from functionally normal to severely impaired. The radiological data that make up DWM have traditionally been utilized to predict these outcomes. Other abnormalities frequently seen in these patients may be more predictive of prognosis than DWM tenet indicators. Furthermore, hydrocephalus is a constant threat in these individuals, with many of them being admitted to the hospital due to it. The study was conducted to identify these items as potential outcome predictors.
Between 1992 and 2013, researchers reviewed all referrals from antenatal anatomy scan suggestive for DWM. They analyzed Outpatient letters and other communications in the neurosurgery archives. The total number of DWM diagnoses was counted. They used Patient status to judge outcomes, ranging from death to normal school attendance. Any other abnormalities were measured and compared to the patients’ results. They found other CNS abnormalities and the size of the cyst to predict poor outcomes. Hydrocephalus and non-CNS abnormalities did not indicate poor outcomes. Furthermore, ventriculoperitoneal shunts were the most efficient of all the treatments tested in this study. The findings suggest a shift in determining DWM prognoses, counseling parents, and a new perspective on hydrocephalus and its treatment contradict current literature.
Reference:thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/28/6/article-p710.xml
