Definition and Diagnostic Controversy

  • "Dandy-Walker variant" refers to posterior fossa anomalies that partially fulfill criteria for Dandy-Walker Malformation (DWM) but lack classical features.
  • Typically applied when:
    • Vermian hypoplasia or agenesis is present.
    • Normal-sized posterior fossa (unlike classic DWM).
    • Cystic enlargement of fourth ventricle with rotation of the vermis.
    • Normal position of torcular Herophili and tentorium cerebelli.

    Issues with the Term

    • The term "Dandy-Walker variant" is controversial:
      • Used inconsistently, leading to confusion and ambiguity.
      • Frequently a "default diagnosis" for varied posterior fossa lesions involving fluid spaces.
      • Its broad and ambiguous application has led to difficulties in classification and prognostication.
      • Expert groups discourage using this term.

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