BHUBANESWAR: Kalia, part of a set of conjoined twins who had been separated from his brother Jaga by a team of doctors at AIIMS Delhi three years ago, had not responded as well to the surgery as Jaga. Doctors said a reason for this could be the fact that the central vein in the brain, which the twins shared when they were conjoined, remained with Jaga after the separation.
Sudhanshu Sekhar Mishra, head of the neurosurgery department at SCB Medical College and Hospital in Cuttack, where Kalia passed away on Wednesday night, explained that a vein had been created for Kalia, who had been joined at the head with Jaga, by using a vein from his thigh.
“It is very rare to have craniopagus twins (one in 25 lakh live births). There are different kinds of craniopagus twins and it was very difficult to separate Jaga and Kalia. The skulls of the two kids were sharing one central vein. During the surgery, Jaga had received the natural vein, while Kalia had received a vein from his thigh region, which was grafted to the vein in his brain,” said Mishra.
He added that the grafted vein had a different structure than the skull vein, and led to complications for the boy. “Another problem is the lack of skull on the baby’s head. If we plan to separate craniophagus twins, we need to cover the brain with skull,” he added.
The neurosurgeon said Kalia did not have 75 per cent brain matter. “Because of this, he was not developing or improving. He was in a vegetative stage. We know that a child in vegetative stage cannot live long,” he added.
Mishra said the SCB team had done its best for Kalia. “These kids have low immunity. He had to be in the hospital under proper medical supervision. The parents of the twins would go in and out of the hospital room with their other two children. They would also travel to their native place and return to the hospital. Kalia might have caught an infection,” he added.
Mishra said Jaga, too, misses a portion of his skull. “Because of this, the brain will not have normal intracranial pressure (ICP) and it will create an obstacle in brain development of the child. If the ICP is not maintained well, the brain will continue to shrink. I think skull surgery should be done soon to cover the brain. We are hopeful of Jaga’s recovery,” he added.