IBRAHIM EL-WAFA
L.m. Otero  /  AP
Wearing helmets for protection, Egyptian twins Mohamed Ibrahim, second from left, and Ahmed Ibrahim, sit with their parents Sabah Abu el-Wafa, left, and Ibrahim Mohammed Ibrahim in Dallas, on Oct. 7.
updated 10/12/2004 1:43:33 PM ET 2004-10-12T17:43:33

One year ago, twin Egyptian boys born joined at the tops of their heads were separated after a 34-hour procedure that doctors warned could have resulted in the death of one or both.

The bubbly 3-year-olds, Mohamed and Ahmed Ibrahim, continue to get therapy, and doctors say their future is looking bright.

“We don’t place any limitations on their improvement,” said Dr. Dale Swift, among the five neurosurgeons who helped separate the twins at Children’s Medical Center Dallas.

Living with their parents in a Dallas apartment, the boys laugh easily, eagerly repeating words and greeting visitors with a “Hi.”

Mohamed has started to walk while holding onto objects. Ahmed is able to count in English and Arabic, stand with some help and is working on walking. While Mohamed is getting around better than Ahmed, Ahmed’s language skills are better than Mohamed’s.

Although they still have feeding tubes, the twins also eat and drink on their own.

“From a cognitive standpoint, they seem to be right on track,” said Dr. Frederick Sklar, another neurosurgeon involved in the separation. “They’re speaking in two languages, from a motor standpoint they’re making progress. We’re really optimistic about what they’ll ultimately be able to do.”

The boys were born June 2, 2001, by Caesarean section to Sabah Abu el-Wafa and her husband, Ibrahim Mohammed Ibrahim in a small town in southern Egypt.

A chance at a normal life
A year later they were brought to the United States by the World Craniofacial Foundation, a Dallas-based nonprofit group that helps children with deformities of the head and face, to be evaluated for surgery.

The twins’ father decided it was worth the risks associated with the surgery to give his sons a chance at a normal life.

Marveling at his sons’ progress, Ibrahim Mohammed Ibrahim said through a translator, “So far it’s been a very good year.”

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Dr. Kenneth Salyer, a craniofacial surgeon who founded the World Craniofacial Foundation, said the procedure to reconstruct the twins’ skulls will take place by January.

Doctors wanted the boys to recover as much as they could before undergoing another surgery, he said. Meanwhile, the twins wear special helmets to protect their heads.

Ahmed still has a shunt in his head to drain spinal fluid from the brain. Both boys have a congenital abnormality of the brain called schizencephaly which is characterized by abnormal clefts.

While the condition is associated with seizures, learning disabilities and some motor impairment, it doesn’t necessarily mean the boys will suffer those afflictions, neurosurgeons said.

“I think they’ve avoided every major complication you could have expected from a surgery of this caliber,” said Dr. David Sacco, a neurosurgeon who participated in the operation.

Salyer, who also performed the separation surgery, said the boys should be able to go home to Egypt a few months after the reconstructive procedure, then return to Dallas for annual checkups.

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