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Well, we are not really aware about the growth of our science, especially in the field of medical and health. One of the best example for this is the recent case of identical twins, who were suffer with a rare health problem known as craniosynostosis. craniosynostosis is a condition in which the sutures or natural divisions in the skull bones fused in the womb, leaving little space for their brain to grow.

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This was the problem of Adhi and Adhri, twins from Kerala, whose heads had grown vertically rather than horizontally. It was noticed by their aunt about four months after their birth, both babies head seems “abnormal” in shape. A few days after their first birthday, in March they came to AIIMS and confirm about the condition of babies. The condition is rare, with 1 in 5,000 cases reported in international literature, and the AIIMS neurosurgery department getting about 10 cases a year. But, for the institute this was the first time that monozygotic twins, who looked identical otherwise, had this abnormal growth, with one twin having a more prominent vertical growth than the other.

Dr. Deepak Gupta, additional professor of neurosurgery at AIIMS who operated on the babies, said “Adhi’s head was swollen more than Adhri’s, and the shapes were different and in surgeries for this condition, we remove the bones and resize and reshape them by artificially breaking them and inducing fractures. But since these were identical twins, we had to resize the bones and shape the heads, to make them look exactly the same.”

Centre Ridging - The mid-line of the skull, which divides the left side and the right side of the brain, were missing in both babies, leading to a “perpendicular bulge” in the skulls.
“The intracranial pressure or the pressure in the brain was very high in both babies. Such high pressure leads to headaches, abnormal brain development and can result in loss of vision,” Gupta added.

Parents were so feared and worried about the different shaped heads of the babies till a day after the surgery.
Binu Mon P R, father of kids and a businessman based in Alleppey said “We named our children after Lord Shiva, because they looked the same. We dressed them the same way, barring the fact that Adhi smiled at his doctors and Adhri started howling, our kids looked the same. It was a huge shock when we first started noticing their heads were odd, and then gradually when Adhri’s head swelled more than Adhi’s.”

The surgery that lasted about eight hours, 4 hours for each baby. In the surgery doctors opened their skulls, extracted the primary bones and then cut and broke them inducing multiple fractures to resize the bones to decrease the brain’s vertical growth and increase horizontal growth.
Dr Gupta explained “We had to ensure that for every re-alignment, we left sufficient space to allow the brain to grow in the new direction. The growth of the brain is maximum till about three years of age, so we had to ensure we did not obstruct that, because that would lead to developmental disorders."

However, doctors were feared about the rare blood group of babies, AB negative for both, but the surgery was done without blood transfusion.

On March 27, after 2 weeks of the surgery, both babies have been discharged and follow-up scans have shown their brains are now growing normally. Doctors said that in the case of Adhi and Adhri, the abnormal growth of the skull was due to the fact that they were twins and chromosomal analysis of the babies has not revealed any causes.

Dr Gupta said “The space in the uterus is obviously restricted when there are twins. Possibly due to this reason the skulls had fused at a premature stage during the pregnancy.”

Sandhya, mother of the beautiful kids said her babies now looks like “real twins”.
“I was obviously worried putting my babies through surgery when they are so young. But doctors said if we delayed the matter their heads would grow bigger and even more different in shape, and their brain development may be flawed. I am glad they have normal heads now, they look like real twins,” she said.

Doctors nodded that the need for future surgery is unlikely due to the absence of any genetic reason for this growth. “Surgeries may have been needed in the mandible and around the ears later in life had this been due to genetic reasons. The twins should grow normally now,” Gupta said.

 
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