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Published in: Child's Nervous System 6/2013

01-06-2013 | Case Report

Central brain herniation in shunted Dandy walker cyst

Authors: Tafadzwa Mandiwanza, Chandrasekaran Kaliaperumal, John Caird

Published in: Child's Nervous System | Issue 6/2013

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Abstract

Introduction

Dandy–Walker Syndrome (DWS) is a constellation of congenital anomalies of the central nervous system consisting of cerebellar vermis hypoplasia or agenesis, cystic dilatation of the fourth ventricle, enlarged posterior fossa, and a high tentorium. Hydrocephalus is a common occurrence in DWS and its treatment varies between shunting-ventriculoperitoneal or cystoperitoneal or both, endoscopic cyst fenestration, and third ventriculostomy. Chronic cerebral herniation is a known complication of treatment in DWS; however, we present an unusual case of central brain herniation.

Case report

A 2 year old boy with shunted DWS presented with status epilepticus. Initial CT brain scan showed no increase in ventricle or cyst size; however, tapping the shunt reservoir did not yield any CSF prompting a shunt revision. Postoperatively, he was very slow to wake and subsequently experienced an episode of fixed pupils and extensor posturing. MRI brain demonstrated severe herniation of both thalami through the tentorium.

Conclusion

This child had chronic central brain herniation (CCBH) secondary to the shunting of his cyst. To our knowledge, this is the first case of CCBH following treatment of DW cyst
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Metadata
Title
Central brain herniation in shunted Dandy walker cyst
Authors
Tafadzwa Mandiwanza
Chandrasekaran Kaliaperumal
John Caird
Publication date
01-06-2013
Publisher
Springer-Verlag
Published in
Child's Nervous System / Issue 6/2013
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-013-2066-z

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