An Anesthetic Experience in a Patient with Dandy-Walker Malformation : A case report

Kim, Seong Su; Kwak, Sangwon; Kim, Young Ki

Case Report

Neuroanesthesia

Anesthesia and Pain Medicine 2008;3(2):139-144.
Published online April 30, 2008.

An Anesthetic Experience in a Patient with Dandy-Walker Malformation : A case report

Seong Su Kim, Sangwon Kwak, Young Ki Kim

Department of Anesthesiology and Pain Medicine, Ulsan University College of Medicine, Gangneung Asan Hospital, Gangneung, Korea. sskim@gnah.co.kr

Abstract

Dandy-Walker malformation is a rare malformation associated with hypoplasia of vermis, a pseudocystic fourth ventricle, upward displacement of the tentorium and lateral sinuses, and anterioposterior enlargement of the posterior fossa. It is frequently associated with genetic anomalies, as well as brain and systemic malformations. Care for these patients requires careful management. Hydrocephalus is present in most patients and clinical presentation is most often heralded by symptoms and signs of hydrocephalus with focal neurologic findings. Treatment is still controversial, and major anesthetic concerns are control of intracranial pressure and evaluation of accompanying organ anomalies. The prognosis is unpredictable and varies mainly according to degree of vermis hypoplasia. We report successful anesthetic management in a child with Dandy-Walker malformation for extra-ventricular drainage.

Key Words: Dandy-Walker malformation, general anesthesia, hydrocephalus, shunt