BALTIMORE-A virtual brain has helped a Hopkins surgeon separate two real brains that shared more than 100 tangled blood vessels.
Now the craniopagus conjoined twins type 2 vertical-born looking in opposite directions-are free to face their own lives after a 28-hour operation at a South African hospital. It’s believed to be the first time intricately linked craniopagus twins have been unjoined without apparent brain damage.
The New Year’s Eve division of 11-month-old Luka and Joseph Banda of Zambia at Ga-Rankuwa Hospital, 30 miles north of Pretoria, was led by pediatric neurosurgeon Benjamin Carson. He rehearsed with a virtual-reality simulator, which merged CT and MRI slices into a detailed tridimensional image of the twins’ joined brains.
Wearing special glasses, Dr. Carson spent many hours observing structures, tracking cerebral vessels, and planning the operation.
Though the brains touched and the twins shared blood vessels, they didn’t share gray matter (see MRI below). Dr. Carson found that the twins’ skulls resembled a long tube holding two brains-with shared vessels in tangles, complexes, and conglomerations.
In the OR, his major surprise was the degree of adhesion of the vessels. Some had to be separated by cutting between their walls. Each vessel had to be traced from origin to drainage, each twin getting his fair share. Though more than 100 vessels had to be cut, only four units of blood were transfused.
The twins are breathing normally and eating solid food. Despite 11 months’ immobility, both began to crawl 14 days postop, wearing protective helmets. They’ll have reconstructive surgery for a bony skull covering. -Elsie Rosner
BALTIMORE-A virtual brain has helped a Hopkins surgeon separate two real brains that shared more than 100 tangled blood vessels.
