title: The separation of Guatemalan craniopagus twins.
abstract: METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  The details and intricacies of the anesthesia and plastic surgery are also outlined.
authors.affiliation: Division of Neurosurgery, UCLA David Geffen School of Medicine, PO Box 957039, Los Angeles, CA 90095-7039, USA.
authors.forename: John
authors.initials: J
authors.lastname: Frazee
authors.forename: Itzhak
authors.initials: I
authors.lastname: Fried
authors.forename: Henry
authors.initials: H
authors.lastname: Kawamoto
authors.forename: Jorge
authors.initials: J
authors.lastname: Lazareff
authors.forename: Jaime
authors.initials: J
authors.lastname: Nieto
authors.forename: Swati
authors.initials: S
authors.lastname: Patel
authors.forename: Mark
authors.initials: M
authors.lastname: Urata
authors.forename: Barbara
authors.initials: B
authors.lastname: van de Wiele
mesh_terms: D000758:Anesthesia / Q000379:methods; D001921:Brain / Q000473:pathology / Q000601:surgery*; D017023:Coronary Angiography / Q000379:methods; D005260:Female; D006166:Guatemala; D006801:Humans; D007223:Infant; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods; D009493:Neurosurgery / Q000379:methods; D011183:Postoperative Complications; D012886:Skull / Q000002:abnormalities / Q000473:pathology / Q000601:surgery*; D013518:Surgery, Plastic / Q000379:methods*; D016896:Treatment Outcome; D014428:Twins, Conjoined / Q000601:surgery*