Neonatal Dandy–Walker syndrome: a case report

TL;DR

A newborn with Dandy–Walker syndrome was diagnosed after being admitted for unrelated symptoms, highlighting the importance of revisiting prenatal imaging.

Contribution

This case emphasizes the value of postnatal MRI in confirming prenatal DWS diagnosis and guiding early management.

Findings

Classic DWS was confirmed in a neonate through postnatal MRI despite prenatal imaging suggesting vermian agenesis.

The infant's unrelated symptoms resolved quickly, allowing discharge with normal feeding.

Early confirmation of DWS enabled timely counseling and follow-up planning.

Abstract

Dandy–Walker syndrome (DWS) is usually identified prenatally or after hydrocephalus-related symptoms emerge. We report a term male neonate in whom classic DWS was incidentally discovered during admission for purpura and mild tachypnea. Although fetal magnetic resonance imaging (MRI) had suggested vermian agenesis, definitive postnatal brain MRI on day 6 confirmed complete vermian absence, left cerebellar hypoplasia, and a large posterior-fossa cyst communicating with the fourth ventricle. The purpura and respiratory symptoms resolved rapidly with supportive care, and the infant was discharged with full oral feeding at 7 days. This case highlights the need to revisit prenatal imaging when neonates present with seemingly unrelated problems; early postnatal confirmation enables timely family counseling, developmental surveillance, and multidisciplinary follow-up.

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