Upon thorough evaluation of the characteristic features of Dandy-Walker malformation, this study underscores the pivotal role of MRI in accurately diagnosing the condition. While CT and ultrasound can assist in identifying DWM, MRI remains the gold standard for early investigation. It offers a comprehensive assessment of key anatomical abnormalities, including posterior fossa enlargement, vermian and cerebellar hypoplasia, and associated supratentorial anomalies. Additionally, MRI effectively determines the extent of hydrocephalus, callosal dysgenesis, and other CNS anomalies, making it paramaunt for guiding prompt surgical procedures and interventions, ultimately enhancing patient outcomes.

Fig 14: This sagittal T1-weighted MRI shows a large retrocerebellar cerebrospinal fluid collection and a normal fourth ventricle and vermis in a patient with mega cisterna magna in Dandy-Walker malformation.

Fig 13: An axial T1-weighted MRI showing an elevated, anteriorly displaced torcular herophili (arrow) and a superiorly displaced posterior fossa cyst.

Fig 12: This sagittal T1-weighted MRI scan in an 11-day-old boy (also see the following image) shows agenesis of the corpus callosum, a hypoplastic brainstem (b), elevation of the torcular herophili (lambdoid-torcular inversion, large arrow), a large fourth ventricle, and a markedly hypoplastic vermis that is rotated superiorly (small arrow).

In conclusion, as the prognosis of DWM is highly variable and related to the severity of both the malformation and the presence of associated cerebral and extracerebral anomalies, alongside surgical interventions, early identification using advanced neuroimaging techniques, such as MRI, becomes undoubtedly essential.