Differential diagnosis: Trepanation

Intentionally opened skulls are considered to be the most fascinating of palaeopathological findings. This paper regards the discovery of a new trepanated skull dating from the Late Bronze and Early Iron Ages (1500–1400 BC) found at a burial site of Bardzryal, Armenia. Attention was first paid to trepanation technique, second—the description of methods of trepanations, third—to surgical procedures, and finally, to the cause of trepanation. The remains were examined by standard macromorphological and X‐ray methods of bioarchaeology. Bone nodules resulting from Dyke–Davidoff–Masson syndrome (DDMS) were observed on the endocranial surface of the frontal bone of a female. Regardless of provenance DDMS, which seems to be a possible cause of trepanation in women, is rarely seen in historic populations. Along with DDMS, porotic hyperostosis and osteomas were also observed. This observation constituted the first evidence of DDMS in the Late Bronze and Early Iron Age Armenia.

Section: Discussionmentioning

confidence: 92%

Dyke–Davidoff–Masson syndrome in the Late Bronze and Early Iron Ages Armenia—a cause of trepanation?

Khudaverdyan

Hovhanesyan²,

Engibaryan

et al. 2018

“…Two linear fractures are visible in the defect, but they were interpreted as the result of taphonomic post mortem damage because they do not reveal any signs of healing (like the margins of the hole). Other possible factors that can result in bone perforation are depressed fractures, metastatic carcinoma, myeloma and infectious diseases (Kaufman et al ., ; Bereczki & Marcsik, ; Nikita et al ., ; Verano, ). However, in all these, the produced lesions are irregular in shape, which does not match the case here presented.…”

Section: Discussionmentioning

confidence: 97%

“…Nowadays, trepanation is a worldwide discussed phenomenon (Andrushko & Verano, ; Bereczki & Marcsik, ; Bereczki et al ., ; Campillo, ; Gresky et al ., ; Erdal & Erdal, ; Nikita et al ., ; Piek et al ., ; Verano, , among others). Nevertheless, only since the end of the 19th century, when it was first realized that ancient people made holes in the skull of the living, has trepanation started to fascinate anthropologists, surgeons, neurologists and the general public.…”

Section: Discussionmentioning

confidence: 99%

Short Report: Evidence of Trepanation on a Female Individual from the Middle Bronze Age Necropolis of Casas Velhas (Melides, Portugal)

Silva

Gil

Soares

et al. 2016

Recent reanalysis of the human remains unearthed from the grave cists of the necropolis of Casas Velhas (Melides, Portugal) from the Southwest Iberian Middle Bronze Age, with a minimal number of 25 individuals (23 adults and 2 non‐adults), allowed relevant anthropological data. This culture, although widespread in southern Portugal and nearby areas of southwest Spain in the Middle Bronze Age, is characterized by the paucity of preserved human remains and thus the anthropological knowledge of these human populations. The adult female skeleton exhumed from cist 30, the last interment of this double burial, exhibit a complete perforation on the right parietal bone. The aim of this paper is to present and discuss this defect, which most probable diagnosis is trepanation. The hole is oval shape exhibiting long term healing. A shallow remodelled area is visible around the defect, which suggests scraping method. No complications or evident reasons for the intervention were observed. In terms of mortuary practices no clear distinction was observed between this individual and others from this cemetery. The features of this trepanation fit in the major points summarized by Silva () for prehistoric Portuguese trepanation. These data sustain the existence of an old tradition of this procedure is this region of Iberia, present, at least, since the Middle Neolithic. Copyright © 2016 John Wiley & Sons, Ltd.

“…Differential diagnosis plays an important role in the interpretation of any changes in bone structure. Numerous pathological and taphonomical conditions can lead to defects on cranial bones (e.g., Kaufmann et al, 1997;Ramseier, 2005;Assina et al, 2014;Toyne, 2015;Verano, 2016). The most context-related conditions will now be presented and discussed.…”

Section: Differential Diagnosismentioning

confidence: 99%

A possible case of symbolic trepanation in Neolithic Central Germany

Nicklisch

Dresely²,

Orschiedt

et al. 2018

Manipulations on prehistoric skulls such as trepanations are among the most fascinating palaeopathological findings though it is not always easy to make a firm diagnosis. This case study presents a lesion on the cranial vault of a Late Neolithic burial in Central Germany. The defect forms an almost lanceolate lesion along the sagittal suture, which had not penetrated the cranial vault. Similar lesions have been found in other areas of Germany and in the Balkans, where they have been interpreted as aborted, incomplete, or symbolic trepanations. This study explores potential causes for the unusual lesion and outlines possible therapeutic reasons for the manipulation of the skull. Comparison with similar cases also raises the question of a symbolic or ritual context. Thus, the study supports the hypothesis of symbolic surgical head manipulation in the European Neolithic.