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Ask the Mental Health Expert Archives 2001-2004

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Dandy Walker Cyst

Q. I have a Dandy Walker cyst. Is there a relationship between Dandy Walker cysts and OCD symptoms? I was diagnosed at age 13. I am a 24-year-old female looking towards removal of the cyst, but I have suffered with severe depression and "crazy" thinking that I have a hard time controlling. Is there a relationship between the cyst and these symptoms?

A. I am not aware of any studies (and I did look!) showing a direct connection between Dandy-Walker Syndrome (DWS) and either depression or obsessive-compulsive symptoms. Just to explain to our other readers, DWS is a congenital brain malformation that affects a part of the brain called the cerebellum, and a fluid-filled channel in the brain, called the fourth ventricle.

DWS may lead to formation of a cyst (fluid-filled sac) that interferes with drainage of cerebrospinal fluid, which in turn may compress and potentially damage surrounding brain structures. The severity and scope of DWS varies considerably from individual to individual--some have the condition their whole lives without knowing it, whereas others may be affected from birth with increased head size (due to hydrocephalus or "water on the brain"), decreased muscle tone, learning problems, and seizures.

More information on DWS may be found at the website www.geocities.com/Heartland/Hills/3919/dws.html). While I did not find studies directly linking DWS with depression or obsessive-compulsive disorder (OCD), it is interesting that some studies of OCD do implicate abnormalities in the cerebellum; e.g., one study by Kim et al (Br J Psychiatry 2001 Oct;179:330-4) found reduced "grey matter" (brain cells) in the cerebellum of patients with OCD. But while this study suggests some type of cerebellar problem in OCD, it does not prove a direct connection between OCD and DWS. Thus, it may simply be a coincidence that you have been diagnosed with both DWS and OCD.

In any case, there is reason to be hopeful that both medication and psychotherapy may be helpful for your depressive and OCD symptoms. If you are not currently in treatment for these problems, I would strongly encourage you to seek it. Ideally, a neuropsychiatrist with experience in OCD would be a good person to consult.

February 2003

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