Doctors have successfully separated the two-year-old conjoined twin boys who suffered a rare condition occurring once in about 2.5 million births and were attached at the skull. It was a marathon surgical procedure that lasted more than 36 hours and involved 40 doctors. 
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Conjoined siblings are identical twins who are born with their skin and internal organs fused together.
About half are stillborn, and the survival rate is between 5-25%.
They develop from a single egg, which splits in the case of healthy twins, but not fully in the case of conjoined siblings.
The twins were born with shared blood vessels and some shared brain tissue.
It was a team work of 40 doctors, 20 nurses and many other paramedical staff.
One of the surgeons involved said the most challenging aspect was to provide a skin cover and repair the holes left in the young boys’ heads after they were separated.
The skin was generated from the expansion of two balloons which were placed inside their heads during the first surgery in August.
The next surgeries involved reconstruction of their skulls.
Conjoined twins who are classified as craniopagus (joined at the cranium) have an extremely rare congenital anomaly.
They are conjoined twins that are fused at any part of the skull, except the face, foramen magnum, skull base and the vertebral column.
The fused structures are most often the cranium, meninges, and dural venous sinuses. Brains tend to be separate; however, may be connected by a bridge of neural tissue. The trunks and limbs are separate.
Exclusive extracranial tissues involvement needs no significant imaging evaluation; however, a CT is needed to study the osseous detail if vault fusion is present. MRI is required to study the degree of brain involvement and MR arteriogram and MR venogram are required to evaluate the status of the cerebral circulation and venous sinuses.
