Rarest of rare case: Asymptomatic Dandy Walker syndrome diagnosed in adult with stroke

Motor examination revealed weakness on right side of face (UMN Type), upper limb and lower limb (Grade 2/5). Increased tone and hyperreflexia present in right upper limb and lower limb. Babinski sign (Plantar reflex) was positive on right side. Sensory system and other cranial nerves examination was unremarkable. CT SCAN suggested:

• Diffuse white matter hypodensity in bilateral fronto-occipital projections, periventricular deep white matter, corona radiata, centrum semiovale, suggestive of acute infarct and mild age related cerebral and cerebellar atrophy.
• Mildly dilated both lateral ventricle, 3rd and 4th ventricle suggestive of communicating hydrocephalus.
• Giant cistern magna appears to be communicating with IVventricle giving "Key hole appearance."

MRI BRAIN was done to confirm above incidental finding and Dandy Walker variant was confirmed.

Patient was treated with antiplatelet and antihypertensive agents and supportive management including physiotherapy and patient improved and subsequently discharged after 12 days of hospitalisation.

"Adult presentation of the Dandy-Walker syndrome is extremely rare.3,4 The extensive search of literature revealed only few case reports where patient never developed evidence of cerebellar involvement till adulthood and Dandy-Walker syndrome was an incidental finding when being investigated for other disability."the team concluded.

For full article follow the link: https://www.japi.org/x28484a4/incidental-presentation-of-dandy-walker-variant-in-66-year-male-patient

Primary source: Journal Of The Association Of Physicians Of India