Dandy–Walker malformation and intermittent explosive disorder: A case report

Dandy–Walker malformation is a group of brain malformations that sometimes present with psychotic features, violent and impulsive behavior, or mood symptoms. Here, we present a case report of a patient with Dandy–Walker malformation who presented with intermittent explosive disorder. A young man, aged 18 years, was brought to the author’s hospital [Hamad Medical Corporation] with anger outbursts, irritable mood, and violent behavior. His magnetic resonance imaging scans showed typical alterations of Dandy–Walker malformation. He also had mild intellectual disabilities and epilepsy. After a few weeks of treatment with sodium valproate 1000 mg/day and risperidone 2 mg/day, his condition improved, and his violent behavior was significantly reduced in 3 months, 6 months, and 1 year of follow-up. There is broad consensus that Dandy–Walker malformation is associated with psychosis and other behavioral abnormalities because of a possible disruption in the prefrontal, thalamic, and cerebellar circuits. The link between Dandy–Walker malformation and intermittent explosive disorder may help us understand this type of brain malformation as a potential psychiatric comorbidity.