Neonatal Dandy–Walker Syndrome: A Case Report

Ying Yang^*

• Department of Emergency Medicine, Zigong Fourth People's Hospital, Zigong, China

Dandy–Walker syndrome (DWS) is a rare neurodevelopment disorder defined by hypoplasia or aplasia of the cerebellar vermis, cystic dilatation of the fourth ventricle and an enlarged posterior fossa [1]. The global incidence is approximately 1/25000–1/35000 live births [2]. Although its anatomy is well characterised, neonatal presentation remains poorly described: most infants are identified prenatally or later in infancy when hydrocephalus or gross motor delay emerges. A 2022 systematic review located only 42 histologically or genetically verified cases presenting within the first 28 days of life, 83% of which were incidental findings on neuro-imaging performed for unrelated neonatal problems such as birth asphyxia, metabolic crisis or sepsis evaluation [3].. While most reports emphasize the malformation itself, few describe the full spectrum of early post-natal presentation when DWS is incidentally discovered during evaluation for unrelated neonatal illness. Purpura or mild respiratory distress as the admitting symptom complex has not been reported previously. We report a term male neonate who was admitted for purpura and mild tachypnoea, in whom brain magnetic resonance imaging (MRI) subsequently revealed classic anatomic features of DWS. This case underscores the importance of revisiting prenatal imaging when common neonatal signs arise, and highlights the need for early post-natal confirmation to enable timely family counselling and developmental surveillance.