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Brain Swelling Halts Conjoined Twin Surgery

US surgeons were forced to halt a delicate and high-risk procedure to separate twin girls joined at the head because of unexpected brain swelling, doctors said Thursday.

Three-year-old Anastasia and Tatiana Dogaru, whose parents are from Romania, were described as "medically stable" at Rainbow Babies and Children's Hospital in Cleveland, Ohio, after a first round of surgery Wednesday to begin separating their skulls.

But doctors were hesitant to go further until they determined the cause of the swelling in the dominant twin, Anastasia, which was discovered after neurosurgeons took out a section of skull to expose the brain tissue.

"After removing the bone, it became apparent that the brain tissue was swollen, despite the fact that measures had been taken to prevent such swelling," chief medical officer Nathan Levitan told a news conference.

"They felt that it would not be safe to cut into the brain tissue or the surrounding blood vessels in any way, without first understanding the cause of the swelling and the low blood pressure," Levitan said.

"As a result, they decided not to continue with surgery at that time," he said, adding that an MRI and angiogram would be studied to determine the next step.

The twins have never looked one another in the face, because the top of Tatiana's head is attached to the back of her sister Anastasia's head. Their brains are connected "in a complex fashion," and they also suffer from heart, organ and limb defects, a hospital statement said. Their condition, known as total angular craniopagus, is extremely rare and considered fatal without treatment, comparable to being diagnosed with a malignant, inoperable brain tumor, it said.

Pre-operation procedures began last month when doctors inserted wire coils into brains' blood vessels to create independent circulation for each child. The girls share the same circulatory system, so that any med
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