Initial Management at Presentation
- Treat associated hydrocephalus: Surgical intervention cannot reverse neurological deficits due to Dandy-Walker malformations, so the main concern is to evaluate and treat the child for hydrocephalus.
- Initial confirmation of treatment: In the initial postoperative period, patients are followed to ensure appropriate response to the shunt and/or fenestration.
- Document improving state: Examination should evaluate for improvement in the signs and symptoms of elevated ICP.
- Infection postoperatively: Patients should be monitored for infection in the first 3–6 months after surgery.
- Treatment failure: Patients should be monitored periodically to ensure the hydrocephalus does not return.
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