Author(s)

András Csókay^1*, István Hudák¹, István Valálik^2,3, Attila Jósvai¹, Bence Trencsényi¹, Előd Égető¹, Bertalan Tóth⁴, Bernadett Csókay⁴, Gergely Csókay⁴

¹Department of Neurosurgery, North-Pest Central Hospital, Budapest, Hungary.
²Department of Pediatric Surgery and Traumatology, St. John’s Hospital, Budapest, Hungary.
³Department of Neurosurgery, St. John’s Hospital, Budapest, Hungary.
⁴Department of Maxillo-Facial Surgery, Semmelweis University Clinic of Maxillo-Facial Surgery, Budapest, Hungary.

Purpose: Challenging cases in neurosurgery require experience, which is gained by operating on a number of similarly difficult cases. However, even in large population centers, there are extremely rare cases, such as craniopagus twins. In these instances, other case-specific solutions are required which were improved in the course of fresh cadaver practice on daily base. Methods: During a 20-month preparation period by fresh cadavers the surgical strategy was developed step by step, comprising five neurosurgical ideas, facilitated by deep Jesus prayers as a spiritual source. Possible causes of postoperative complications that occured on 33d postoperative day were also analyzed. Results: During surgery, these nuances proved to be useful, which is also reflected by the postoperative clinical results. One of the twins advanced to a GOS score of 5three months after the surgery. The other twin, despite nonsurgical septic complications, continued to progress well, but on postoperative day 33 for seemingly unknown reasons, she suffered a severe cerebral hemorrhage, which significantly delayed her rehabilitation. A thorough revision of the whole process much later revealed a pitfall that could have a role in this complication. Conclusions: The challenging neurosurgical separation of the craniopagus twins was carried out successfully with the help of five novel neurosurgical refinements, which were found during 300 fresh cadaver practices. Mistakes can serve as a lesson. We hope that the procedures developed and the knowledge gained can be applied in the future.

Craniopagus, Conjoined Twins, Fresh Cadaver Practice

Csókay, A. , Hudák, I. , Valálik, I. , Jósvai, A. , Trencsényi, B. , Égető, E. , Tóth, B. , Csókay, B. and Csókay, G. (2023) Role of Fresh Cadaver Practice and Jesus Prayers on Daily Base in Innovations of a Difficult Neurosurgical Operation (Craniopagus Separation). Open Journal of Modern Neurosurgery, 13, 189-201. doi: 10.4236/ojmn.2023.134023.