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The separation of Guatemalan craniopagus twins

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Abstract

Case report

The particularities of the surgical procedure for the separation of craniopagi twins performed at UCLA in 2002 are presented. The main difficulty for the neurosurgeons was that the twins shared a common sagittal sinus and that one of the sisters had a poorly developed collateral venous system, thus anticipating a set of postoperative clinical problems. During surgery, the response of the brain to the progressive occlusion of the venous bridges was monitored with EEG and Doppler ultrasound. One of the sisters had a large intracerebral hematoma that was evacuated and later developed hydrocephalus, which was treated with a ventriculoperitoneal shunt.

Outcome

One of the sisters had a basically uneventful recovery while the other contracted E. coli meningitis 8 months after surgery, thus impairing her motor and cognitive development.

Discussion

The details and intricacies of the anesthesia and plastic surgery are also outlined.

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References

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Acknowledgements

The authors would like to acknowledge the outstanding postoperative care that the twins are receiving from the various specialists involved in their ongoing management.

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Authors and Affiliations

  1. Division of Neurosurgery, UCLA David Geffen School of Medicine, PO Box 957039, Los Angeles, CA 90095-7039, USA

    John Frazee, Itzhak Fried, Jorge Lazareff & Jaime Nieto

  2. Department of Plastic and Reconstructive Surgery, UCLA David Geffen School of Medicine, PO Box 957039, Los Angeles, CA 90095-7039, USA

    Henry Kawamoto Jr & Mark Urata

  3. Department of Anesthesia, UCLA David Geffen School of Medicine, PO Box 957039, Los Angeles, CA 90095-7039, USA

    Swati Patel & Barbara van de Wiele

Authors
  1. John Frazee
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  2. Itzhak Fried
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  3. Henry Kawamoto Jr
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  4. Jorge Lazareff
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  5. Jaime Nieto
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  6. Swati Patel
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  7. Mark Urata
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  8. Barbara van de Wiele
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Corresponding author

Correspondence to Jorge Lazareff.

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Frazee, J., Fried, I., Kawamoto, H. et al. The separation of Guatemalan craniopagus twins. Childs Nerv Syst 20, 593–600 (2004). https://doi.org/10.1007/s00381-004-0979-2

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  • DOI: https://doi.org/10.1007/s00381-004-0979-2

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