Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2022; 10(7): 2275-2280
Published online Mar 6, 2022. doi: 10.12998/wjcc.v10.i7.2275
Y-shaped shunt for the treatment of Dandy-Walker malformation combined with giant arachnoid cysts: A case report
Zhi-Qiang Dong, Yan-Fei Jia, Zhen-Shan Gao, Qiao Li, Liang Niu, Qiang Yang, Ya-Wen Pan, Qiang Li
Zhi-Qiang Dong, Yan-Fei Jia, Zhen-Shan Gao, Qiao Li, Liang Niu, Qiang Yang, Ya-Wen Pan, Qiang Li, Department of Neurosurgery, The Second Hospital of Lanzhou University, Lanzhou 730030, Gansu Province, China
Zhi-Qiang Dong, Ya-Wen Pan, Qiang Li, Institute of Neurology, The Second Hospital of Lanzhou University, Lanzhou 730030, Gansu Province, China
Author contributions: Dong ZQ conceived and coordinated the study, designed, performed and analyzed the experiments, and wrote the paper; Jia YF, Gao ZS, Li Q, Niu L, Yang Q, Pan YW and Li Q carried out data collection and analysis, and revised the paper; all authors reviewed the results and approved the final version of the manuscript.
Informed consent statement: Written informed consent was obtained from the patient’s guardian.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qiang Li, MD, Doctor, Department of Neurosurgery, The Second Hospital of Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou 730030, Gansu Province, China. strong908@163.com
Received: July 21, 2021
Peer-review started: July 21, 2021
First decision: September 1, 2021
Revised: September 25, 2021
Accepted: January 25, 2022
Article in press: January 25, 2022
Published online: March 6, 2022
Processing time: 223 Days and 18.8 Hours
Abstract
BACKGROUND

Dandy-Walker malformation (DWM) was first reported in 1914. In this case report, a pediatric case was complicated with giant and isolated arachnoid cysts in the right cerebellar hemisphere along with the typical DWM.

CASE SUMMARY

The patient was at 20 mo old boy, with the complaint of staggering for more than 2 mo. He was admitted to the hospital due to high intracranial pressure and staggering. At admission, the patient had typical manifestations of high intracranial pressure, including vomiting, poor appetite and feeding difficulty. Physical examination revealed increased head circumference, closed anterior fontanelle, unstable standing, staggering, leaning right while walking and ataxia. After admission, he was diagnosed with DWM accompanied by giant isolated arachnoid cysts in the posterior fossa. He underwent Y-shaped three-way valve repair for treating differential pressure between the supratentorial hydrocephalus and the subtentorial arachnoid cysts at once. The child recovered well after the surgery.

CONCLUSION

In this case, supratentorial and subtentorial shunts were placed, which solved the problem of differential pressure between the supratentorial and subtentorial parts simultaneously. This provides useful information regarding treatment exploration in this rare disease.

Keywords: Arachnoid cyst; Cysto-peritoneal shunt; Dandy-Walker malformation; Ventriculoperitoneal shunt; Case report

Core Tip: Dandy-Walker malformation (DWM) is a rare congenital malformation characterized by partial or complete dysplasia of the cerebellar vermis, cystic dilation of the four ventricles, upward displacement of the tentorium, increased anteroposterior diameter of the posterior fossa, and connection between the posterior fossa cysts with the four ventricles in most cases. DWM with giant isolated arachnoid cysts in the posterior fossa was treated with a combination of supratentorial and subtentorial cyst shunts safely and effectively.