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Preparation for Treatment of Dandy-Walker Syndrome in Children

Indications for Surgery

  • Symptomatic hydrocephalus: Dandy-Walker malformations with significant hydrocephalus require surgical intervention. Those without significant hydrocephalus may be followed conservatively.

Preoperative Orders

  • Antibiotics: The authors administer vancomycin prior to shunt procedures.
  • Clamp time for CSF drain: Clamping the drain several hours prior to the procedure may help. ICP should be monitored when the drain is clamped, and the patient should be monitored for symptoms.
  • Surgical site scrub: A sterile scrub is performed prior to the procedure.

Anesthetic Considerations

  • ICP precautions: Patients should be considered to have elevated ICP.

Devices to Be Implanted

  • Shunt materials: Ventriculoperitoneal shunt or ventriculostomy as indicated.