Dandy Walker Malformation

Dandy-Walker Malformation (DWM) is a rare but serious congenital brain disorder that affects the development of the cerebellum (the part of the brain that controls movement and coordination) and the fluid-filled spaces around it. It is characterized by: Underdevelopment or absence of the cerebellar vermis Enlargement of the fourth ventricle Cystic formation near the base of the skull Often accompanied by hydrocephalus (excess cerebrospinal fluid in the brain) In Bangladesh, cases of Dandy-Walker Malformation are often diagnosed late, sometimes only after the child presents with macrocephaly, delayed milestones, or seizures. With proper early neurosurgical intervention, many of these children can have improved developmental outcomes. 🎯 Causes and Risk Factors While the exact cause is not always known, contributing factors include: Genetic mutations or chromosomal abnormalities Intrauterine infections Maternal diabetes or malnutrition Exposure to teratogens during pregnancy Family history of neural tube defects or brain malformations Low access to antenatal screening and neonatal neuroimaging in rural Bangladesh results in underdiagnosis and delayed treatment. 📊 Prevalence and Bangladesh Context Though globally rare, Dandy-Walker Malformation may be underreported in Bangladesh due to: Lack of specialized pediatric neurodiagnostics in peripheral hospitals Limited availability of fetal MRI or advanced prenatal imaging Delayed referrals to neurosurgeons after hydrocephalus develops Lack of awareness among general pediatricians and obstetricians Dr. Md. Nafaur Rahman is working to raise awareness about early neuroimaging in high-risk pregnancies and timely pediatric neurosurgical consultation. 🧒 Common Symptoms in Infants and Children Rapidly increasing head size (macrocephaly) Bulging fontanelle or tense soft spot Poor muscle coordination or balance (ataxia) Developmental delay, especially in motor skills Seizures or abnormal eye movements Irritability, vomiting, and lethargy (signs of increased intracranial pressure) In some cases, facial abnormalities or other brain malformations 🧪 Diagnosis of Dandy-Walker Malformation Accurate diagnosis requires: Prenatal ultrasonography (usually in the second trimester) Fetal MRI for better brain structure visualization Postnatal MRI or CT scan to assess brain anatomy Neurological evaluation to determine functional impact Genetic testing if multiple anomalies are present In Bangladesh, MRI availability is growing in tertiary care centers like NINS, but rural referrals remain a challenge. 🛠️ Neurosurgical Treatment Options There is no cure for the underlying brain malformation, but surgical treatment focuses on managing symptoms, especially hydrocephalus and increased intracranial pressure. 🔧 Surgical Options Include: ✅ Ventriculoperitoneal (VP) Shunt Surgery The most common and effective treatment Drains excess cerebrospinal fluid from brain to abdomen Performed by Dr. Nafaur with high success rates ✅ Endoscopic Third Ventriculostomy (ETV) A minimally invasive option for selected cases Avoids long-term shunt dependency ✅ Posterior Fossa Decompression Rarely required, but considered in severe cyst compression “Timely CSF diversion surgery can prevent permanent brain damage and improve quality of life.” — Dr. Md. Nafaur Rahman 🧠 Postoperative Care and Follow-Up After surgery, Dr. Nafaur’s team provides: ICU monitoring and pain management Monitoring for shunt blockage or infection Regular developmental assessment Physical and occupational therapy referrals Parental counseling and long-term follow-up care 🌟 Prognosis and Long-Term Outlook The outcome for children with Dandy-Walker Malformation depends on: Severity of cerebellar underdevelopment Presence of hydrocephalus and timing of surgery Co-existing genetic or neurological disorders Access to post-surgical rehabilitation With proper care, many children can attend school, walk, and live with independence, although some may need special education or therapies. Dandy-Walker Malformation in Bangladesh – Why Early Detection Matters Many families present late with complicated hydrocephalus Surgery can be life-saving and prevent long-term disability There is urgent need for national neonatal screening programs Public awareness and early referral systems can change outcomes 👨‍⚕️ Why Choose Dr. Md. Nafaur Rahman? One of Bangladesh’s most respected pediatric neurosurgeons 🎓 Assistant Professor at NINS, the national hub for neuro care 🔬 Advanced skills in CSF diversion, ETV, and brain malformation surgery 👨‍👩‍👧‍👦 Holistic care that includes family education and rehab support 💰 Affordable packages for low-income families across Bangladesh 📍 Available at NINS and Bangladesh Paediatric Neurocare Centre 📞 Contact for Dandy-Walker Malformation Evaluation and Treatment in Bangladesh Dr. Md. Nafaur Rahman Assistant Professor, Pediatric Neurosurgery, NINS Chief Consultant, Bangladesh Paediatric Neurocare Centre 📞 For Serial / Appointment: 📱 01912988182 | 01607033535 🌐 Website: www.neurosurgeonnafaur.com