Cranial trepanation and healing process in modern patients—Bioarchaeological and anthropological implications

Partiot, Caroline; Lepetit, Aliénor; Dodré, E; Jenger, Camille; Maureille, Bruno; Liguoro, Dominique; Thomas, Aline

doi:10.1111/joa.13266

Cited by 10 publications

(6 citation statements)

References 67 publications

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“…Interestingly, all these areas showed evidence of Neolithic settlements, while several more, belonging to a later period, were discovered in what is now central America (Mexico and Peru). [22,23,24,25,26] The most popular theory claims that the very first craniotomies were probably performed during the prehistoric era for reasons related to magic or religion, or may be related to an initiation practice, as hypothesized by Broca. [24] It may have been performed as an exorcism method to get rid of demons/malignant spirits infesting the human brain.…”

Section: Resultsmentioning

confidence: 99%

“…[22,23,24,25,26] The most popular theory claims that the very first craniotomies were probably performed during the prehistoric era for reasons related to magic or religion, or may be related to an initiation practice, as hypothesized by Broca. [24] It may have been performed as an exorcism method to get rid of demons/malignant spirits infesting the human brain. It seems that skull drilling accounted for religious importance, since from some of these skulls, diskettes of bony tissue were removed post mortem, which were later then worn as amulets around the neck (the so-called "rondelles", described for the first time, by Prunières, in 1783).…”

Section: Resultsmentioning

confidence: 99%

“…It seems that skull drilling accounted for religious importance, since from some of these skulls, diskettes of bony tissue were removed post mortem, which were later then worn as amulets around the neck (the so-called "rondelles", described for the first time, by Prunières, in 1783). [24,26] As time progressed, the primary use of craniotomy was for therapeutic purposes. The encephalic decompression accounted for clinical improvement in certain pre-existing neurological symptoms, such as headache, paresis, and convulsive states.…”

Section: Resultsmentioning

confidence: 99%

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Landmarks in the Traumatic Brain Injury A Retrospective Study

Al-Awar¹

2023

ACMR

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As one might expect, prehistoric brain surgery lacked knowledge of the anatomy, concept recognition of the disease, and comprehension of the disease’s origin. Unfortunately, failure to deeply understand these important principles delayed the progression of medical and surgical practice. Trepanation may be one of the oldest surgical interventions for which archaeological evidence is present. In the 1990s, standardized guidelines were developed and established for the management of traumatic brain injury. They included protocols regarding the pharmaceutical therapy and the management of increased ICP. Since then, research has improved TBI survival. Evidence of trepanation practice and other techniques in pre-Columbian Mesoamerica is demonstrated by the cranial remains in pre-Columbian burials, iconographic artworks, and post-colonial reports. The intellectual understanding of neurosurgery developed during the golden age of ancient Greece where no surgeon restricted oneself in strict to neurosurgery. Head injuries on the other hand appear to have been abundant; an expected result of wars and internecine conflict, as recorded by Herodotus, Thucydides, and Homer. Then and now, war remains the primary source of study material for the improvement of knowledge regarding head injuries. Surgical procedures for the management of even minimal lesions of the theca cranica, continued throughout the 16 th and 17 th Century. The surgical technique, with cross-shaped skin incision and the instruments used (trephine, lever, scalpel, gouge, protector of the meninx, etc.) would remain unchanged with respect to the past, but one should take notice at the improved quality of the materials and the ameliorated precision with which the instruments were made. Some instruments appeared to be real work of art, as shown by the findings now displayed in museums and in illustrations of the times. The most ancient technique of craniotomy involved using abrasive instruments to thin down the bony wall. Subsequently, circular incisions were progressively made deeper, or a series of small holes were made in a circular fashion. The remaining bony bridges between these small holes would be broken down. The two latter methods that continued to be used for a very long period depended on using metal instruments.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Landmarks in the Traumatic Brain Injury A Retrospective Study

Al-Awar¹

2023

ACMR

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“…One possibility is that they were placed in the trephined hole post-operation to reduce the hole’s size and encourage osseous healing. In clinical literature, examples of bone re-insertion (autologous cranioplasty) are well documented, albeit with mixed results as to whether it indeed encourages healing [ 85 ]. The replacement of bone in an empty space essentially acts as a physical scaffold, which is thought to facilitate remodeling after the removal of bone [ 86 ].…”

Section: Discussionmentioning

confidence: 99%

Cranial trephination and infectious disease in the Eastern Mediterranean: The evidence from two elite brothers from Late Bronze Megiddo, Israel

et al. 2023

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Here we present the paleopathological profiles of two young adult males, identified as brothers through ancient DNA analysis, who were buried together beneath the floor of an elite early Late Bronze Age I (ca. 1550–1450 BC) domestic structure at the urban center of Megiddo (modern Israel). Both individuals displayed uncommon morphological variants related to developmental conditions, and each exhibited extensive bone remodeling consistent with chronic infectious disease. Additionally, one brother had a healed fracture of the nose, as well as a large square piece of bone cut from the frontal bone (cranial trephination). We consider the potential etiologies for the appearance of the skeletal anomalies and lesions. Based on the bioarchaeological context, we propose that a shared epigenetic landscape predisposed the brothers to acquiring an infectious disease and their elite status privileged them enough to endure it. We then contextualize these potential illnesses and disorders with the trephination procedure. The infrequency of trephination in the region indicates that only selected individuals could access such a procedure, and the severity of the pathological lesions suggests the procedure was possibly intended as curative to deteriorating health. Ultimately, both brothers were buried with the same rites as others in their community, thus demonstrating their continued integration in society even after death.

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“…The edges of the holes will experience a growth process from a sharp and vertical stage to a smooth and inclined stage. The external edge will expand due to continual bone mass loss, which will eventually form a “funnel‐shaped” feature (Partiot et al, 2020). This process can also explain factors of the morphological formation characteristics in the three cases from the Mapai cemetery, mainly owing to the combined effects of drilling technology and healing mode but not simply due to the scraping technology.…”

Section: Discussionmentioning

confidence: 99%