She will be back in about three months' time for further surgery.

The eight-year-old girl had come here for a cranioplasty, an operation to give her a hard covering for the top of her head, where her brain is protected only by skin now.

The gap is a legacy of the operation that separated her from her twin, Ganga, in a five-day operation at the Singapore General Hospital seven years ago. The cranioplasty could not go ahead, however, because of a serious problem with Jamuna's spinal cord.

This defect was therefore fixed this time around, leaving the cranioplasty for her next visit here later this year.

Jamuna and Ganga were born joined at the top of their heads, with their brains entwined.

After the operation to separate them, they returned home to Nepal. Ganga died of pneumonia last year.

Fearing for her surviving twin, the girl's mother, Madam Sandhya Shrestha, appealed to doctors here who had separated the twins, to give Jamuna a hard covering for her head.

Her brain, covered only by skin, has been left open to the effects of atmospheric pressure, which have stunted her development.

It has also put her at risk, since an accidental knock to that part of her head could kill her.

Paediatric neurosurgeon Keith Goh, one of two lead surgeons who separated the twins, agreed to do the cranioplasty for free at East Shore Hospital, where he now works.

Mrs Alawiyah Gurung, a Singaporean married to a Nepali, enlisted the help of well-wishers to pay for Jamuna and her mother's flight here, and for their stay.

An MRI scan of her head showed a blockage at the top of her spinal column, a defect called a chiari malformation.

The blockage was forcing spinal fluid into her spinal cord, damaging the nerves in her spine. Left uncorrected, the condition would have paralysed or killed her in a few years. This was at the root of her splitting headaches and the continued weakness in her right arm and leg, despite regular physiotherapy.

The successful operation to correct the spinal defect was paid for from what is left of funds donated by the public for their separation surgery.

But complications set in about a fortnight later, when a shunt - put in seven years ago to drain fluid into her abdomen - broke, possibly as a result of a stronger flow of fluid from her brain down her spinal column.

She had to be operated on twice to fix that. Now, she needs a few months to recover and to build up her strength before the cranioplasty.

Mrs Gurung has promised to bring her back for that later this year.

salma@sph.com.sg