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lüll Cystic malformations of the posterior fossa: differential diagnosis clarified through embryologic analysis Kollias SS; Ball WS Jr; Prenger ECRadiographics 1993[Nov]; 13 (6): 1211-31Cystic or cyst-like malformations of the posterior fossa represent a spectrum of disorders, including the Dandy-Walker malformation, vermian-cerebellar hypoplasia, mega cisterna magna, and arachnoid cyst. Differentiation of these lesions may be difficult with routine cross-sectional imaging; however, an accurate diagnosis is essential for proper treatment planning and genetic counseling. Dandy-Walker malformation is easily diagnosed on the basis of the classic triad: complete or partial agenesis of the vermis, cystic dilatation of the fourth ventricle, and enlarged posterior fossa. Vermian-cerebellar hypoplasia is a general classification that describes congenital malformations with a normal-sized posterior fossa, varying degrees of vermian and cerebellar hypoplasia, and a prominent retrocerebellar cerebrospinal fluid space that communicates freely with a normal or dilated fourth ventricle. Mega cisterna magna can be asymmetric and can manifest apparent mass effect, simulating the appearance of an arachnoid cyst; therefore, ventriculography or cisternography may be needed to demonstrate communication of the cystic mass with the subarachnoid space. A careful review of the embryologic development is essential in understanding these malformations and in making a more accurate radiologic diagnosis.|*Diagnostic Imaging[MESH]|Abnormalities, Multiple/*diagnosis/genetics[MESH]|Arachnoid Cysts/*diagnosis[MESH]|Brain/*abnormalities[MESH]|Cerebellum/*embryology[MESH]|Cisterna Magna/abnormalities[MESH]|Cranial Fossa, Posterior[MESH]|Dandy-Walker Syndrome/*diagnosis[MESH]|Diagnosis, Differential[MESH]|Humans[MESH] |