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AN ADULT CASE OF A DANDY-WALKER SYNDROME Hiroshi Ishimitsu 1 , Shimpei Namba 1 , Susumu Nakasone 1 1Department of Neurosurgery, Iwakuni National Hospital pp.583-589
Published Date 1979/6/1
DOI https://doi.org/10.11477/mf.1406204423
  • Abstract
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A 48 year old female was transferred to our hospital on February the 11th with consciousness disturbance presumably following head injury. She was drowsy at admission with no other neurolo-gical deficit.

It was apparently noticed at first glance her head was extremely big. The head was scaphocephalic in shape, the circumference of which was 80 cm with significant bulging in occipital region. Re-markable enlargement of posterior fossa with ele-vation of the torcular Herophili and bulging of thinned occipital bone was demonstrated by plain skull X-P examination. Her consciousness became alert after residual moderate disorientation disap-peared in two weeks of admission.

Detail examination was performed to make the exact diagnosis of basic intracranial defect causing remarkable head enlargement. Bilateral retrograde brachial angiography (BAG) demonstrated a large avascular area which occupied two third of the space of posterior fossa in angiography, and signi-ficantly elevated superior cerebellar arteries. Addi-tionaly, hypoplastic posterior inferior cerebellar arteries were markedly depressed and intermingled (capillary blush) anteroinferiorly to the avascular area. Pneumoventriculography revealed symmetri-cal enlargement of bilateral ventricles. CT ex-amination demonstrated a large cyst, and residual two nodules which were separated from each other anterolaterally to the cyst. With In-111-cisterno-graphy, neither ventricular reflux nor reflux into the cyst of the posterior fossa was demonstrated, showing noncommunicating hydrocephalus in this case. From these examination, Dandy-Walker synd-rome was most suspected.

In this reported case, the age of the patient was 48 year old when she was first examined in detail to be diagnosed as to Dandy-Walker syndrome, furthermore clinical neurological deficit which made her admit the hospital was thought to be caused by the head injury. Such a late appearance of clinical symptoms of Dandy-Walker syndrome was discussed as well.


Copyright © 1979, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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