Abstract:
Dandy-Walker complex (DWC) consists of a continuum of brain malformations involving the posterior fossa, often leading to psychiatric manifestations during adulthood. We discussed the case of a young woman with Dandy-Walker variant (DWV) and a comorbid complex neuropsychiatric presentation, who was diagnosed with an eating disorder, obsessive-compulsive disorder, and a tic disorder. Afterwards, we conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020-compliant systematic review reappraising all evidence of psychiatric outcomes in adults with DWC. Overall, 34 studies were eligible for data extraction, comprising 36 patients. Psychiatric profiles were more common among young adult males, with DWC lesions, especially DWV subtype, being often discovered incidentally after admission to mental health inpatient facilities. Most patients were diagnosed with psychosis and bipolar disorder, often comorbid with cognitive impairment. Psychotropic polypharmacy was frequently prescribed, generally leading to complete recovery. Evidence from our case report and systematic review indicates the importance of monitoring long-term psychiatric sequelae among adult patients with DWC malformations.
摘要:
Dandy-Walker复合体(DWC)由累及后颅窝的一系列脑畸形组成,通常导致成年期间的精神病表现。我们讨论了一名年轻女性的情况,该女性患有Dandy-Walker变体(DWV)和并发复杂的神经精神病学表现,他被诊断出患有进食障碍,强迫症,还有抽动障碍.之后,我们进行了符合系统评价和荟萃分析(PRISMA)的2020年系统评价的首选报告项目,重新评估了DWC成人精神病结局的所有证据.总的来说,34项研究符合数据提取条件,包括36名患者。精神病情况在年轻成年男性中更为常见,DWC病变,尤其是DWV子类型,通常是在进入精神健康住院设施后偶然发现的。大多数病人被诊断为精神病和双相情感障碍,常伴有认知障碍。精神药物疗法经常被处方,通常导致完全恢复。来自我们的病例报告和系统评价的证据表明,在患有DWC畸形的成年患者中监测长期精神病后遗症的重要性。