Cranial dysraphism mistaken for trephination

Stewart, T. D.

doi:10.1002/ajpa.1330420310

Cited by 26 publications

(25 citation statements)

References 3 publications

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“…The cranial variant observed on this calvarium is centred at bregma, though the intersection of the coronal and sagittal sutures is still visible (Figure ). The defect is a depression of the bone, ellipsoid in shape, and is similar to what several authors describe as a “saucer” (Gass, ; Ortner, ; Stewart, ; Webb & Thorne, ). The depression is smooth walled and shows no exposure of the diploë, signs of bone resorption, or porosity.…”

Section: Descriptionsupporting

confidence: 70%

“…The majority of the bioarchaeological literature identifies defects located at bregma as congenital herniations/dysraphisms (Gass, ; Ortner, ; Powell, ; Stewart, ; Webb & Thorne, ), although some lesions are more difficult to assess resulting in diagnoses that remain undifferentiated (Blau, ; Sublett & Wray, ). Only six examples of defects at bregma exist in the literature and consistent in each of these papers is the description of the shape, position, and location of the defect (Table ).…”

Section: Bioarchaeological Literature Overviewmentioning

confidence: 99%

“…Published reports regarding cranial lesions located at bregma are common, with several examples from around the world in both the bioarchaeological and clinical literature (Blau, ; Drolet, ; Drolet, Clowry, McTigue, & Esterly, ; Gass, ; Held, Rose, Hamm, & Fölster‐Holst, ; Ortner, ; Powell, ; Stewart, ; Sublett & Wray, ; Webb & Thorne, ). The bioarchaeological literature tends to identify a particular type of bregmatic lesion as cranial dysraphism.…”

Section: Introductionmentioning

confidence: 99%

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A probable example of cranial dysraphism from New Orleans, Louisiana

Halling¹,

Seidemann²

2018

Intl J of Osteoarchaeology

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Cranial dysraphism, a pathological condition resulting from a neural tube defect, is a rarely reported condition in archaeological and clinical literature. A defect at bregma was identified on human remains recovered from New Orleans, Louisiana, when exhumation of several commingled bodies occurred in a paupers' cemetery in 2015. Initial speculation regarding the cause of the condition consisted of trauma, pathological condition, a natural variant, or the result of a congenital defect. A differential diagnosis was utilised to approach the breadth of potential causative factors, incorporating clinical information on the bony response of soft tissue defects common in modern reports. However, during a review of the bioarchaeological literature, an alternative explanation for the feature, one that did not result from typically reported causes, revealed that this observed defect was likely an example of the rarely reported condition known as cranial dysraphism. Through review of both clinical and bioarchaeological data, the resulting diagnosis observed here is supported through the unique characteristics that several other authors have identified as associated with cranial dysraphism. Unique features of this bony defect include the smooth walls of the depression, a saucer‐like shape with an anterior rim built up of cortical bone, lack of diploë exposure, a perforation at the base of the saucer, and the retention of cranial sutures. Although the defect also closely resembles the bony response to a cyst, the perforation and anterior rim are supportive of its diagnosis as a cranial dysraphism. This case study of a single occurrence of cranial dysraphism is reported to assist practitioners in differentiating between this condition and other potential causes of anomalies of similar appearance.

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Section: Descriptionsupporting

confidence: 70%

Section: Bioarchaeological Literature Overviewmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A probable example of cranial dysraphism from New Orleans, Louisiana

Halling¹,

Seidemann²

2018

Intl J of Osteoarchaeology

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“…These include biparietal atrophy (Ortner, 2003), and the congenital meningocoele (Stewart, 1975;Webb & Thorne, 1985). The whole of the defect is also not consistent with trepanning (Ackerknecht, 1967;Lisowsky, 1967;Stewart, 1975), which has not, in any case, been documented in any sample from east Tennessee or the broader environs. The presence of necrotising bone in the wound bed of Burial 21 also suggests that an interventive debridement for a scalping survivor (essentially trepanning) did not occur.…”

Section: Burial 21 From the Hampton Sitementioning

confidence: 87%

Adding insult to injury: opportunistic treponemal disease in a scalping survivor

Smith

2008

Intl J of Osteoarchaeology

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Although the taking of scalps is arguably a perimortem trophy-taking behaviour, cases of scalping survival are occasionally reported in the historical documents of the American Colonial Period and the 19 th century westward expansion. Survival cases are also detected in pre-Columbian bioarchaeological contexts. Although scalp avulsion injuries can heal without complication, often the process is compromised by secondary osteomyelitis, usually attributable to environmentally ever-present Staphylococcal or Streptococcal bacteria. A scalping survivor case from the late prehistoric (AD 1200-1600) Hampton site (40RH41) of East Tennessee unusually displays infectious sequelae in the area denuded by scalp avulsion which are pathognomonic for treponemal disease (caries sicca, stellate scarring). This infection is probably a reflection of the easy opportunity afforded by the large size of the wound bed, poor post-trauma hygiene, and direct inoculation of the diploë by a ubiquitous Treponema.

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“…Stewart (1975) points out that survival with a meningocoele in a prehistoric community before adequate surgical techniques were available would have been low, except for those individuals having small dysraphisms. Obviously, those persons having delicate soft tissues exposed would be very susceptible to head trauma, infection, and death resulting from meningitis or some similar condition.…”

Section: Discussionmentioning

confidence: 96%

A congenital meningocoele in prehistoric Australia

Webb

Thorne

1985

American J Phys Anthropol

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This report concerns a congenital meningocoele in a young adult Aboriginal female from north-western New South Wales, Australia. The fact that this individual reached adulthood throws new light on the attitude of these nomadic people towards such conditions. Evidence of this kind may prompt also a re-evaluation by prehistorians and anthropologists of the popularly held belief that all such malformations were automatically eliminated by infanticide. The discovery of this form of pathology helps provide new information not only on past cultural attitudes towards disease, but its frequency and geographical incidence, and adds to our knowledge concerning the range of pathological conditions suffered by prehistoric societies worldwide.

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Cranial dysraphism mistaken for trephination

Cited by 26 publications

References 3 publications

A probable example of cranial dysraphism from New Orleans, Louisiana

A probable example of cranial dysraphism from New Orleans, Louisiana

Adding insult to injury: opportunistic treponemal disease in a scalping survivor

A congenital meningocoele in prehistoric Australia

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