Child's Nervous System

, Volume 20, Issue 8–9, pp 593–600

The separation of Guatemalan craniopagus twins

  • John Frazee
  • Itzhak Fried
  • Henry KawamotoJr
  • Jorge Lazareff
  • Jaime Nieto
  • Swati Patel
  • Mark Urata
  • Barbara van de Wiele
Special Annual Issue

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.

Keywords

Craniopagus Venous drainage Scalp surgery 

References

  1. 1.
    Khan ZH, Tabatabai SA, Saberi H (1999) Anesthetic and surgical experience in a case of total vertical craniopagus. Surg Neurol 52:62–67CrossRefPubMedGoogle Scholar
  2. 2.
    Georges LS, Smith KW, Wong KC (1987) Anesthetic challenges in separation of craniopagus twins. Anesth Analg 66:783–787PubMedGoogle Scholar
  3. 3.
    Wong KC, Ohmura A, Roberts TH, Webster LR, Cook GL (1980) Anesthetic management for separation of craniopagus twins. Anesth Analg 59:883–886PubMedGoogle Scholar
  4. 4.
    Wong TG, Ong BC, Ang C, Chee HL (2003) Anesthetic management for a five-day separation of craniopagus twins. Anesth Analg 97:999–1002PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • John Frazee
    • 1
  • Itzhak Fried
    • 1
  • Henry KawamotoJr
    • 2
  • Jorge Lazareff
    • 1
  • Jaime Nieto
    • 1
  • Swati Patel
    • 3
  • Mark Urata
    • 2
  • Barbara van de Wiele
    • 3
  1. 1.Division of NeurosurgeryUCLA David Geffen School of MedicineLos AngelesUSA
  2. 2.Department of Plastic and Reconstructive SurgeryUCLA David Geffen School of MedicineLos AngelesUSA
  3. 3.Department of AnesthesiaUCLA David Geffen School of MedicineLos AngelesUSA

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