Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
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Comparative Study Clinical Trial
Mild trigonocephaly and intracranial pressure: report of 56 patients.
We report the surgical results in patients with mild trigonocephaly and clinical symptoms. Since high intracranial pressure (ICP) was noted during surgery in our previous patient series, we began to record intraoperative ICP. The importance of treating mild trigonocephaly with clinical symptoms is stressed. ⋯ Although our patients had mild trigonocephaly, their ICP and pulse pressure were high. Decompressive cranioplasty in cases of mild trigonocephaly is feasible.
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There are many problems facing the neurosurgeon when separating craniopagus twins. The condition is rare, with an incidence of 1 in 2.5 million births. As such there is a paucity of information in the literature regarding strategies for separation. ⋯ The aim of this article is to discuss the preoperative work-up, technical details of surgery, postoperative care and lessons learned with respect to the separation of craniopagus twins.
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Review Case Reports
Craniopagus twins: embryology, classification, surgical anatomy, and separation.
With recent advances in brain imaging and neurosurgical techniques, there has been a renewed interest in the surgical separation of craniopagus twins. Successful separation in recent cases, along with widespread publicity, has attracted craniopagus twins from all over the world to be referred to pediatric neurosurgical centers for evaluation and consideration for surgical separation. ⋯ We discuss here our experience with three sets of craniopagus twins and our approach to staged separation.
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Review Case Reports
Ischiopagus and pygopagus conjoined twins: neurosurgical considerations.
Neurosurgeons are familiar with the challenges presented by craniopagus twins, but other types of conjoined twins may also have neurosurgical implications. We report our experience in the management of ischiopagus and pygopagus conjoined twins. ⋯ Ischiopagus and pygopagus conjoined twins manifest an interesting array of spinal abnormalities, which present challenges, not only at the time of separation, but also in their long-term management.
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Craniopagus twinning is a rare embryological event occurring in 1 in 2.5 million births. ⋯ The separation of craniopagus twins demands a multidisciplinary team approach. Utilizing preoperative neuroendovascular techniques to occlude shared vascular anastomotic channels, complex total vertical craniopagus twins can now be successfully separated in a one-stage procedure.