Dima, age 5, before surgery in 1989.

Dima, age 15, when he arrived in Dallas in August 2000 for second-stage surgery.

Dima's Father Stated:

"My son Dima was born in 1984 with a birth defect. From the very beginning of his life we began a struggle for his health. When he was one and a half years old, Soviet surgeons performed Dima’s first operation, which only served to prevent increased pressure on his brain. But they informed us they could not make him a normal child’s face. The disease not only restricted growth of the skull bones, but also deformed his face. At first it was barely noticeable, but the more he grew, the more it changed his face."

"We travelled to various cities in the Soviet Union, showing Dima to different specialists, but no one consented to operate on him. Finally we went to Moscow. There at the neurosurgical research institute one of the surgeons suggested showing Dima to the American specialists who were to arrive in Moscow shortly. At first we didn’t believe anything would come of it. Somehow it was beyond belief that from a far-off land some doctors would come to help our son."

"But a miracle actually happened in May 1989 when Dr. Salyer and his team arrived in Moscow. The american surgeons demonstrated to the whole world true compassion and kindness by their treatment of our children. They selected 10 Soviet children, including Dima, to take to Dallas for treatment in December 1989."

Background

Ahmed & Mohamed Ibrahim were born in a small town 500 miles south of Cairo on June 2, 2001. They are identical twin boys, conjoined at the skull. They are normal little boys in every other way, but just happened to be born fused at the top of their skulls. Their extremely rare condition, known as craniopagus twinning, happens in only 2% of conjoined twins' births or roughly one in 10,000,000 live births. The way in which they are conjoined at the top of the head has meant laying on their backs since birth.

From birth through six months of age the twins were cared for at the University of Cairo Hospital under the leadership of Dr. Nasser Abdel-Al and a team of dedicated pediatric physicians. Soon after their birth, doctors in Egypt contacted renowned craniofacial surgeon Dr. Kenneth Salyer in Dallas, TX about the possibility of having the twins evaluated for surgical separation. Plans were made for the twins to come to Medical City Dallas Hospital for a battery of tests to be performed and for examination by Dr. Salyer's team of surgeons. Finally, after several months of waiting the twins arrived in Dallas on June 22nd, 2002. A team of three pediatric physicians and two nurses accompanied the boys on their long trip from Egypt to Dallas.

While in Dallas the twins have had a myriad of medical tests to help the craniofacial and neurological surgeons in the evaluation of their surgical separation. Many of these tests have been based on medical imaging studies like computed tomography (CT) scans and magnetic resonance imaging studies (MRI). These tests have confirmed that the twins have largely separate brains and share only about 10% of their brain tissue. MRI and CT studies have also revealed that many of the vascular structures are dependent and are inter-twined in a very complex maze of vessels. The twins inter-dependence of drainage vessels poses a unique challenge to surgeons because of the need for truly independent systems after separation.

On April 28th, 2003 the International Craniofacial Institute's surgery team placed tissue expanders under the twins' skin. Details of this procedure can be found in the Press Release section of this website. After an estimated 3-5 months of skin expansion the twins will be ready for separation surgery.

Current Status

The twins are currently undergoing tissue expansion to create more soft tissue before their separation surgery. More skin is needed to cover the defects that will be created by the separation. Tissue expanders were placed April 28th, 2003 at Medical City Dallas Hospital and the twins will be cared for at Medical City Dallas Hospital for an additional 3-5 months during expansion. When expansion is complete the twins will move to Children's Medical Center of Dallas for the separation surgery.

Help Still Needed!

While the World Craniofacial Foundation has raised the $125,000 needed for Children's Medical Center to proceed with surgery, there are still many more costs to offset in the future. It is estimated that this procedure could cost upwards of $2,000,000 and that is just for the surgery. It is likely that the boys, father and nurses who have been in Dallas for a year will remain approximately two years more, under the care of the World Craniofacial Foundation. The twins will need further reconstruction of the bone of their heads because that cannot be done at the time of separation. They will also require intensive physical therapy and rehabilitation after surgery. The physical therapy is very important to their full recovery and there is no way they can receive this care in Egypt because of the fact that the family lives 500 miles from Cairo. Therefore there will be large and ongoing expenses to the World Craniofacial Foundation and your support is needed in any amount.