Abstract：
Dandy-Walker malformation (DWM) is a posterior fossa malformation characterized by a huge posterior fossa cyst in communication with the fourth ventricle. Hydrocephalus is associated with more than 80% of cases and is usually treated by shunting. Despite infection being a common complication of the shunt, abscess formation within the cyst was reported only once.
A neonate affected by DWM developed a posterior fossa abscess following a shunt infection. The purulent collection was refractory to standard treatment (antibiotics and burr hole drainage); therefore, an endoscopic approach was performed in order to remove the purulent collection under direct vision. This material was aspirated with the help of an endoscopic ultrasonic aspirator. The outcome was favorable, with a resolution of infection and re-implantation of the ventriculo-peritoneal shunt. Surprisingly, post-operative radiological examination showed substantial modification of the anatomy of the posterior fossa with disappearing of the Dandy-Walker cyst. To the best of our knowledge, this is the first documented report of a true Dandy-Walker malformation that modified its anatomical appearance over time.
Endoscopic aspiration of intracranial purulent collection should be considered a valid option to manage complicated cases. An endoscopic ultrasonic aspirator may make the procedure more effective and faster.
A neonate affected by DWM developed a posterior fossa abscess following a shunt infection. The purulent collection was refractory to standard treatment (antibiotics and burr hole drainage); therefore, an endoscopic approach was performed in order to remove the purulent collection under direct vision. This material was aspirated with the help of an endoscopic ultrasonic aspirator. The outcome was favorable, with a resolution of infection and re-implantation of the ventriculo-peritoneal shunt. Surprisingly, post-operative radiological examination showed substantial modification of the anatomy of the posterior fossa with disappearing of the Dandy-Walker cyst. To the best of our knowledge, this is the first documented report of a true Dandy-Walker malformation that modified its anatomical appearance over time.
Endoscopic aspiration of intracranial purulent collection should be considered a valid option to manage complicated cases. An endoscopic ultrasonic aspirator may make the procedure more effective and faster.
摘要：
背景：Dandy-Walker畸形（DWM）是一种后颅窝畸形，其特征是与第四脑室连通的巨大后颅窝囊肿。脑积水与80％以上的病例有关，通常通过分流治疗。尽管感染是分流的常见并发症，囊肿内脓肿形成仅报告一次。
方法：一名受DWM影响的新生儿在分流感染后出现后颅窝脓肿。化脓性集合对标准治疗（抗生素和毛刺孔引流）是难以处理的；因此，为了在直视下清除化脓性集合，我们进行了内窥镜检查。在内窥镜超声抽吸器的帮助下抽吸该材料。结果是有利的，解决了感染并重新植入了脑室-腹膜分流术。令人惊讶的是,术后放射学检查显示后颅窝的解剖结构发生了实质性改变，Dandy-Walker囊肿消失。据我们所知,这是第一个有记录的关于真正的Dandy-Walker畸形的报告，随着时间的推移改变了它的解剖外观。
结论：颅内化脓性集合的内镜抽吸术应该被认为是处理复杂病例的有效选择。内窥镜超声抽吸器可以使手术更有效和更快。
方法：一名受DWM影响的新生儿在分流感染后出现后颅窝脓肿。化脓性集合对标准治疗（抗生素和毛刺孔引流）是难以处理的；因此，为了在直视下清除化脓性集合，我们进行了内窥镜检查。在内窥镜超声抽吸器的帮助下抽吸该材料。结果是有利的，解决了感染并重新植入了脑室-腹膜分流术。令人惊讶的是,术后放射学检查显示后颅窝的解剖结构发生了实质性改变，Dandy-Walker囊肿消失。据我们所知,这是第一个有记录的关于真正的Dandy-Walker畸形的报告，随着时间的推移改变了它的解剖外观。
结论：颅内化脓性集合的内镜抽吸术应该被认为是处理复杂病例的有效选择。内窥镜超声抽吸器可以使手术更有效和更快。
