VACTERL (vertebral anomalies, anal atresia, cardiac defect, tracheoesophageal fistula, renal anomaly, limb anomalies) is an association of anomalies with a wide spectrum of phenotypic expression. While the majority of cases are sporadic, there is evidence of an inherited component in a small number of patients as well as the potential influence of nongenetic risk factors (maternal diabetes mellitus). 

Presence of [[hydrocephalus]] has been reported in VACTERL patients (VACTERL-H) in the past, with some displaying branchial arch anomalies. Velazquez et al. report the unique case of an infant of diabetic mother with VACTERL association and a branchial arch anomaly-in the absence of hydrocephalus
((Velazquez D, Pereira E, Havranek T. Neonate with VACTERL Association and a
Branchial Arch Anomaly without Hydrocephalus. AJP Rep. 2016 Mar;6(1):e74-6. doi: 
10.1055/s-0035-1566297. Epub 2015 Nov 2. PubMed PMID: 26929876.)).