O Neurologista: Revista Clínica e Terapêutica

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World Neuro 2017: Craniopagus parasiticus: Parasitic head protuberant from temporal area of cranium, a case report - Getachew Desta Alemayehu - Bahir Dar University

Getachew Desta Alemayehu

Craniopagus parasiticus is an unprecedented clinical case and it is uncommon not typical for various cases nitty gritty from different composition. The head of parasitic twins is distending from the transient district of skull. Parasitic head had two twisted lower limbs; one is unreasonably straightforward joined to the mass; long bones of two-sided lower members and some pelvic bones. After investigation of the mass, the stomach related tract was seen at this point no chest organs and other stomach organs. There was a simple labium however no vaginal opening. In asset restricted nations, maternal age or nourishing elements may assume a job in craniopagus parasiticus.

Case Presentation:

A 38-year-old multigravida (gravida V para IV) lady of Amhara ethnicity was alluded from a wellbeing place to our medical clinic because of delayed second phase of work at 42+1 weeks. She felt that her pregnancy didn't contrast from her past pregnancies. She had been taking injectable contraception for a long time. She had no family ancestry of any inborn abnormalities. She had four solid live births at term and all are sound. She had antenatal follow up for four visits where she was screened for human immunodeficiency infection (HIV), syphilis, hepatitis B infection (HBV), and for diabetes (just an irregular glucose test) however not sonographic screening. She got lockjaw inoculation and iron supplementation. She didn't take some other prescription during her pregnancy. She introduced to our emergency clinic in the wake of working for around 35 hours both at home and at the wellbeing community. She was assessed on landing in our medical clinic; she had compression, term-sized gravid uterus, and fetal heart beat was 112. On advanced pelvic assessment her cervix was completely widened, the station of the head was high, and the throbbing umbilical rope was before the giving part burst layer, which showed a troublesome transvaginal conveyance. Thus, the group scrambled for crisis cesarean area. A cesarean segment was done under general sedation and a live child young lady weighing 4200 g was conveyed. The placenta was single and typical. Her Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores were 7 and 9 at 1 and 5 minutes, separately. She seemed, by all accounts, to be terribly ordinary aside from her parasitic co-twin was joined at the transient zone of her noggin. Her twin was an accidental finding and during the troublesome extraction her left uterine course was cut off and fixed.

Medical procedure was performed to the infant multi week after her conveyance after the fundamental examination and arrangement was finished. The parasitic co-twin was completely extracted in the activity that took around 6 hours. Her postoperative period was smooth and uneventful; she easily nursed on the bosom well. She was transfused with a determined two units of new entire blood. Fourteen days after the medical procedure she was released solid with a plan for postnatal development. After partition, a pathologic assessment showed that skin secured the body of the parasitic twin. The parasitic twin had two twisted lower appendages, one of which was simple. After analyzation of the mass of the body, the digestive system was seen however there were no chest organs or stomach organs. The long bones of the respective lower appendages and some pelvic bone were found in the appendages of the parasitic twin. There was additionally a simple labium yet no vaginal opening.

Conclusion:

In conclusion, the causes of craniopagus parasiticus are still unknown due to a rarity of cases and the limited number of studies on it. There have been only nine or ten cases of craniopagus parasiticus, of which only three survived past birth and were documented in the literature. We hope that genetic scientists and researchers continue to investigate this case because they might find explanations of the birth defect, and provide answers and improve the prognosis and the life chances of twins with craniopagus parasiticus. In our case, the baby girl is in good health and suckling breast milk after a successful separation was performed. The possible etiologies of craniopagus parasiticus still unknown due to a rarity of cases. Doctors, genetic scientists, epidemiologists and researchers continue to investigate this case as the reasons that could give clue to birth defect and to provide answer for better prognosis of cases and improved the life chances of the twins. This case will have some input in the effort to know the etiology and pathogenesis of this new-born.