case_images: PMC10629322_01
case_images: Images of the patient at the age of 5 days. (a and b) Clinical photographs show the skin-covered mass of size 3 cm*3 cm*1 cm with a hairless part covered with fibrous tissues. (c) Three-dimensional computed tomography shows sagittal suture dilatation and an occipital bone defect. (d and e) On sagittal and axial magnetic resonance imaging, a large posterior fossa, vermis hypoplasia, and a posterior fossa cyst communicating with the fourth ventricle can be seen, confirming the Dandy-Walker syndrome (DWS). The cystic cerebrospinal fluid-intensity small swelling in the occipital region is a large cyst communicating with a posterior fossa cyst through a defect in the occipital bone, suggesting an occipital meningocele associated with DWS. Hydrocephalus and occlusion of the aqueduct are not found.
case_images: SNI-14-353-g001.jpg
case_images: PMC10629322_01_SNI-14-353-g001.jpg
case_images: F1
case_images: A hairless part covered with fibrous tissues was found above the mass [Figures 1a and b]. Three-dimensional computed tomography (CT) at the age of 5 days showed sagittal suture dilatation and an occipital bone defect with swelling in the occipital region [Figure 1c]. Magnetic resonance imaging (MRI) demonstrated a cystic cerebrospinal fluid (CSF) intensity small swelling in the occipital region communicating with a posterior fossa cyst through a defect in the occipital bone suggestive of OMC [Figures 1d and e].
case_images: Images of the patient at the age of 50 days. (a and b) Clinical photographs show that the skin-covered subcutaneous mass in the occipital region has enlarged to 7 cm*7 cm*2.5 cm. The hairless part covered with fibrous tissues is further thinned, and the inside of the dura is seen through it. (c and d) On sagittal and axial magnetic resonance imaging, an occipital meningocele communicating with a posterior fossa cyst and fourth ventricle, and mild ventricular enlargement indicating hydrocephalus are seen. (e) Three-dimensional computed tomography venography demonstrates the run of the sinuses and veins in a defective part of the bone. The left transverse sinus runs along the left edge of an occipital bone defect, but there is neither sinus nor veins in its right margin. Both the occipital bone defect and sagittal suture dilatation are enlarged.
case_images: SNI-14-353-g002.jpg
case_images: PMC10629322_01_SNI-14-353-g002.jpg
case_images: F2
case_images: The size of the subcutaneous mass in the occipital region was 7 cm * 7 cm * 2.5 cm at the age of 50 days [Figures 2a and b]. MRI at the age of 50 days showed a markedly increased OMC communicating with a posterior fossa cyst and fourth ventricle, as well as mild ventricular enlargement indicating hydrocephalus [Figures 2c and d]. Furthermore, contrast CT venography (CTV) demonstrated the run of the sinuses and veins in a defective part of the bone [Figure 2e].
case_images: (a) Intraoperative photograph shows the left transverse sinus (black arrow) running along the left edge of the meningocele sac after the dura incision. (b and c) On sagittal and axial magnetic resonance imaging 2 months after surgery, the contracted occipital meningocele and ventricles are seen.
case_images: SNI-14-353-g003.jpg
case_images: PMC10629322_01_SNI-14-353-g003.jpg
case_images: F3
case_images: When the dura was incised, the left transverse sinus ran along the left edge of the meningocele sac [Figure 3a]. No surgical complications were encountered, and an MRI 2 months after surgery showed that the ventricles and the cyst had shrunk postoperatively [Figures 3b and c].