 Hello everyone, I am Dr. Bhavani Hg, junior resident in department of radiology from Goa Medical College. Today I am reporting a case on dandy worker variant with associated occipital meningocele and jovacil. Introduction Dandy worker continuum also referred as dandy worker spectrum or dandy worker complex. It is a spectrum of anomalies that include dandy worker moll formation, verminian hypoplasia, black pouch cyst and mega cisterna magna. It is the most common congenital cerebellar moll formation of posterior fossa. Most common presentation is increased intracranial pressure secondary to hydrocephalus. Dandy worker continuum can be associated with the Jobert anomaly in some cases. Jobert anomaly is an autosomal recessive disorder where there is a variable degree of cerebellar verminian agenesis is noted. History Baby born at 38.6 weeks of gestation out of normal vaginal delivery with upper score of 8 out of 9. Developed sinosis, seizure and decreased activity after 24 hours of life and shifted to NSU for observation. The metabolic and hematological workup were revealed normal study. Seizure episodes were persisted till one month of life and was an anti-epileptic. Parents also noticed a small swelling in the occipital region. Cranial UST was performed and revealed dilatation of ventricular system with VH ratio of 0.45 and trapezoid-shaped gap is noted between the cerebellar MSPF. Likely suggestive of verminian hypoplasia. MRI was performed and revealed hypoplasia of cerebellar vermes is noted with cystic dilatation of fourth ventricle which is seen to communicate with enlarged cisterna magna. Imaging features are suggestive of dandee wakum inflammation. The superior cerebellar peduncle appears thick, elongated, abnormally oriented, perpendicular to the dorsum of the pons with interpeduncular system, raising possibility of associated jober syndrome. Broad-based meningocell is noted in suboxypital region with urination of Psi. Subapendymal nodules are noted adjacent to the frontal arms of the lateral ventricle. Which is seen to follow grey matter in signal intensity. Suggestive of atherotopia. Discussion. In dandee wakum variant, there is variable degree of inferior verminian and cerebellar hypoplasia. The retro cerebellar CSF collection communicates with normal or mildly enlarged fourth ventricle via prominent velecular. The tentorial position and size of posterior fossa are normal. Coronal images through posterior fossa may show absence of vermus. The brainstem is usually normal and hydrocephalus is an uncommon association. Dandee wakum continuum is a spectrum of anomaly that includes dandee wakum malformation, verminian hypoplasia, black pouch cyst and mega cisterna magna. Dandee wakum malformation. It is the most common posterior fossa malformation. Characterized by triad of hypoplasia of vermus and cephalod rotation of verminian reminence. Cystic dilatation of fourth ventricle extending posteriorly. Enlarged posterior fossa with toriocular lambda inversion. Verminian hypoplasia. Reduced verminian tissue below the vestigial decline line. Superior rotation of vermus, increased segment of verminian angle. Posterior fossa is of normal size. Black pouch cyst, ependymal line protrusion of protrusion from fourth ventricle. Normal size and morphology of vermus. Elevated vermus, increased segment of verminian angle. Mega cisterna magna. Enlarged retro cerebellar CSF more than 10 mm. No mass effect seen. Normal vermus. Fluid crossed by veins and foc cerebellar may scale up and remodel oxypec. Differential diagnosis. Retro cerebellar arcanoid cyst. Cyst is located behind the vermus and fourth ventricle does not communicate with it. No hydrocephalosis noted. Craneal meningocene. Craneal meningocene is characterized as herniation of only meninges. Whereas N-capylocele includes herniation of meninges and neural tissue. The term capylocele includes both of these malformations. The association between dandy ochre spectrum and meningocene is rare. The developmental defect usually occurs around 6th or 7th weeks of intrauterine development. Jobar syndrome. It is a rare inherited autosomal recessive disorder. Systemic characteristic neuro imaging findings for Jobar syndrome was reported by Mariam et al. as molar tooth site. Which is referred as elongated, thickened and horizontally oriented superior cerebellar peduncle. A deep interpeduncular fossa and verminian hypoplasia. In addition, four ventricles is enlarged and distorted. There is variable involvement of supratentorial neuro parenchyma and brainstem in about 30% of cases. The brainstem may be involved in the form of dysmorphic tectum and midbrain, thickening and elongation of midbrain and small pons. There is absence of the accusation of superior cerebellar peduncle and corticospinal tract on the diffusion tensor imaging. Differential diagnosis is verminian and pontocerebellar hypoplasia. Treatment. Early surgical treatment should be offered to the patient with oxypetal meningocene associated with dandy wokum alphamation. There is limited data available on long term outcome of children with Jobar syndrome. Persistent neuromotor developmental retardation is a feature of surviving individual. Patient with associated retinal dysplasia appears to have a poorer pregnancy. Extreme care need to be taken when administrating any any agent that causes respiratory depression as individual with Jobar syndrome are exclusively sensitive to this effect. Genetic counseling is required as the condition is autosomalization. These are my references. Thank you.