Craniopagus: Overview and the implications of sharing a brain
Keywords:Craniopagus, Conjoined twins, Thalamus, Brain, Surgical Separation
Craniopagus twins, who are conjoined at the head, are uncommon and often misunderstood. While craniopagus is rare in itself, Krista and Tatiana Hogan are unique even among craniopagus twins: their brains are connected. In this review, I will explore the history of craniopagus as well as our current understanding of the malformation. Furthermore, I will discuss surgical separation techniques, classification systems, and how these have led to higher survival rates in separated craniopagus twins. Surgical separation of craniopagus twins is perhaps the most formidable of all neurosurgery operations, particularly in the presence of shared neural tissue. Krista and Tatiana fall into this daunting category. The risk of neural damage, coupled with circulatory complications, led Krista and Tatiana’s physicians to conclude a separation would be too dangerous. Consequently, Krista and Tatiana are left with a connection that is both novel to documented research and exquisitely mysterious. They possess what their pediatric neurosurgeon Dr. Doug Cochrane has called a “thalamic bridge” (Dominus, 2011a). Krista and Tatiana’s thalamic bridge will provide significant insight into the study of cognition and behaviour, and may even have significant implications to the philosophy of mind. Furthermore, their connection will be accompanied by major social change, as we must redefine our definition of what it means to be an individual. For us to understand how being part of a pair is more important than being an individual to one’s identity, we must shift our perspective and eliminate our preconceived notions of individuality.
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