Separation of craniopagus twins: the Brisbane experience.

INTRODUCTION: 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. SURVIVAL RATES: Over the last 20 years, there has been a gradual improvement in survival rates due to a combination of improved imaging, surgical/anaesthetic techniques and postoperative care. Currently, survival rates following surgery are at 50-60%. More information regarding this condition is needed to make surgical separation a safer event. AIM: 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.