The Surgical Separation of Siamese Twins Conjoined by the Heads (Cephalopagus Frontalis) Followed by Normal Development

Baldwin, Maitland; Dekaban, Anatole S.

doi:10.1136/jnnp.21.3.195

Cited by 24 publications

(11 citation statements)

References 10 publications

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“…In the others there were important dural defects. Most often there was a dural shelf on the one side of the coronal junction, the remaining part being separated by leptomeninges only, which may be very dense as in the case of Baldwin and Dekaban (1958 6. Relationship between the estimation ofthe longitudinal axis and operative results.…”

Section: Discussionmentioning

confidence: 99%

Craniopagus twins

Todorov

Cohen

Spilotro

et al. 1974

Journal of Neurology, Neurosurgery & Psychiatry

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Section: Discussionmentioning

confidence: 99%

Craniopagus twins

Todorov

Cohen

Spilotro

et al. 1974

Journal of Neurology, Neurosurgery & Psychiatry

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“…Without meaning to doubt the importance of biogenic amines for the regulation of sleep, we find it difficult to accept the relevance of the crossed-circulation experiments for the condition of normal sleep. Robertson (1953), Baldwin andDekaban (1958), O'Connell (1964;1968), together with Franklin et al (1958) and Wolfowitz et al (1968), have observed in six pairs of craniopagus twins independence of sleeping and waking in spite of extensive connections in the circulation of the babies. In two of these cases even a continuity of brain substance was found at operation.…”

Section: Case Historymentioning

confidence: 95%

Polygraphic sleep study in craniopagus twins: (Where is the sleep transmitter?)

Lenard

Schulte

1972

Journal of Neurology, Neurosurgery & Psychiatry

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SU MM AR Y By means of polygraphic recordings complete independence of the sequence of sleeping and waking and of the two sleep states (REM and NREM) could be demonstrated in twins extensively conjoined at the skulls. Functionally important connections in the circulation of the two babies were found during subsequent preoperative investigations. These observations are at variance with the hypothesis of an extraneuronal humoral sleep-inducing factor based on crossed-circulation experiments in animals; moreover they raise a new question about the transportation of the sleepregulating biogenic amines.The union in craniopagus twins may be of any extent from a small superficial connection of two apparently complete individuals to a malformation resulting in the impression of a single head with two faces. Whether surgical separation is a possibility or not depends primarily on the extent and intimacy of the union. Before the necessary meticulous information on anatomical details is obtained in preoperative diagnosis, the crucial question has to be answered whether the twins are two complete individuals with two separate brains or not.We could quickly demonstrate two independently functioning brains in twins extensively conjoined at the skull by polygraphic registration of their behaviour, especially of their sleep states and stages.Crossed circulation experiments in animals have led to the postulation of an extraneuronal humoral sleep-inducing factor. Our results with polygraphic and further diagnostic procedures do not appear to be consistent with such a hypothesis.CASE HISTORY

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“…The incidence ofcraniopagus (conjoined) twins is so rare, at less than one in 2.5 million births (0 'Connell 1964) that only relatively few cases have been recorded in the world medical literature (Warschauer 1909, Cameron 1928, Leirer 1932, Barbosa 1949, Grossman et al 1953, Roherrson 1953, Voris et al 1957, Wi/son and Srorer 1957, Baldwin and Dekaban 1958, Noror 1963,0 'Cvnnell 1964, Frank/in 1964, Wv(!oH'irz et al 1968, Kvhama et al 1972, Tvdvrvv 1974. We have had the opportunity to perform various electrophysiological studies on one set ofthese twins joined at the head and are reporting data that could have significant implications for the understanding ofvarious neurophysiological phenomena.…”

Section: Introductionmentioning

confidence: 97%

Neurophysiological Studies on Conjoined Twins

Hughes

Fino

1984

Neuropediatrics

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EEG, VEP and BAEP studies were performed on conjoined (craniopagus parieto-occipitalis) twins, born prematurely without any common neural tissue, but with shared venous channels and contiguous posterior poles. At thirty-three wks (CA) the EEG of one of the twins showed higher amplitudes and less quiescence, suggesting a more mature cerebrum but the same twin also showed longer latencies in the BAEP, suggesting a less mature brainstem. Sleep spindles at four and a half months frequently occurred at the same time in both of the twins, at times synchronous and at other times with a latency of onset 0.5-0.8 sec from one to the other, providing further evidence for a circulating "sleep-promoting factor". VEPs were recorded that were distinctive of each of the twins. Flash stimulation of one twin produced VEPs in the other that were characteristic, not of the stimulated twin, but of the other, suggesting that evoked responses from one area can activate non-volume conducted responses from another region characteristic of that latter region, presumably by physical contiguity alone.

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The Surgical Separation of Siamese Twins Conjoined by the Heads (Cephalopagus Frontalis) Followed by Normal Development

Cited by 24 publications

References 10 publications

Craniopagus twins

Craniopagus twins

Polygraphic sleep study in craniopagus twins: (Where is the sleep transmitter?)

Neurophysiological Studies on Conjoined Twins

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