Morphometric mp-parameters and signal characteristics of mr-study of thebrain in estimation of the efficiency of operative treatment of a patient with dandy-walker anomaly and hyd rocephalia (clinical observation)

Development of objective markers for visualization of the efficacy of surgical treatment is an urgent problem and is important for the choice of further treatment tactics in patients with Dandy-Walker anomaly combined with hydrocephalus.
The aim was to demonstrate the effective use of endoscopic treatment techniques in patients with subcompensated hydrocephalus and Dandy-Walker anomaly and to evaluate the possibility of using morphometric indicators and signal characteristics of the brain MR imaging in determining their effectiveness.
Materials and Methods. We present a rare clinical observation of a 37-year-old female patient suffering from Dandy-Walker anomaly with hypertension-hydrocephalus syndrome in the subcompensation stage; endoscopic triventriculocysternostomy was performed. Examination was performed: head MRI, phase-contrast magnetic resonance imaging (PCMRI) with cardiosynchronization before and after surgery 6 months later on “Ingenia” 3 Tesla magnetic resonance imager (Philips). Measurements of ventriculometry and morphometric indicators of bone-brain structures of the brain were performed before and after surgical treatment.
Results. Clinical improvement of the patient’s condition was observed after the performed minimally invasive intervention. FKMRI with cardiosynchronization in dynamics after 6 months confirmed the functioning of the third ventricular floor stoma and a slight decrease in the width of the third ventricle. Of the morphometric indices, an increase in the pontomezencephalic angle from 56.7° to 79.7° and in the mammillopontine distance from 9.32 mm to 10.3 mm were noted.
Conclusion . When Dendy-Walker anomaly is combined with hypertension-hydrocephalic syndrome in the subcompensation stage, a triventriculocysternostomy is performed as the first stage. The use of morphometric indicators of the bone-brain structures in combination with ventriculometry and signal characteristics of MRI examination is an accessible method in the work of a multidisciplinary city hospital, which does not require special software. The observation demonstrates the efficacy of triventriculocysternostomy in the treatment of patients with ADS combined with subcompensated hydrocephalus syndrome and the possibility of using radiological diagnostic methods to assess the dynamics of MRI picture before and after surgery.

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