Evaluation of endocranial bony changes in relation to tuberculosis in the Robert J. Terry Anatomical Skeletal Collection (Washington, DC, USA)

Spekker, Olga

doi:10.14232/phd.9714

Cited by 8 publications

(23 citation statements)

References 30 publications

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“…The Terry Collection serves as an invaluable resource for anthropological and medical research, including defining and refining diagnostic criteria for specific infectious diseases, such as TB, in osteoarchaeological series from the pre-antibiotic era [37]. As part of a comprehensive research project [41], macromorphological characteristics, frequencies, and co-occurrences of pathological alterations probably related to different manifestations of TB were evaluated on all individuals (N = 302) recorded to have died of TB (e.g.,…”

Section: Methodsmentioning

confidence: 99%

Tracking down the White Plague: The skeletal evidence of tuberculous meningitis in the Robert J. Terry Anatomical Skeletal Collection

et al. 2020

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Paleopathological diagnosis of tuberculosis (TB) essentially relies on the identification of macroscopic lesions in the skeleton that can be related to different manifestations of TB. Among these alterations, granular impressions (GIs) on the inner skull surface have been considered as pathognomonic features of tuberculous meningitis (TBM). GIs may be established by pressure atrophy of the tubercles formed on the outermost meningeal layer during later stages of TBM. Although GIs were used as diagnostic criteria for TBM in the paleopathological practice since the late 20 th century, their diagnostic value has been questioned. To contribute to strengthening the diagnostic value of GIs, a macroscopic investigation-focusing on the macromorphological characteristics and frequency of GIs-was performed on skeletons of known cause of death from the Terry Collection. The χ 2 analysis of our data revealed that GIs were significantly more common in individuals who died of TB than in individuals who died of non-TB causes. Furthermore, GIs were localized on the inner surface of the skull base and of the lower lateral skull vault. The localization pattern and distribution of GIs on the endocranial surface resemble that of the tubercles observed in the affected meninges during the pathogenesis of TBM. Our results strengthen the tuberculous origin of GIs and imply that they can be considered as specific signs of TBM. Therefore, GIs can be used as diagnostic criteria for TBM in the paleopathological practice, and the diagnosis of TBM can be established with a high certainty when GIs are present in ancient human bone remains.

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Section: Methodsmentioning

confidence: 99%

Tracking down the White Plague: The skeletal evidence of tuberculous meningitis in the Robert J. Terry Anatomical Skeletal Collection

et al. 2020

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“…The objectives of our paper are: [37]. As part of a comprehensive research project [38], macromorphological characteristics, frequencies, and co-occurrences of different types of pathological bony changes probably related to TB were evaluated on all individuals (N = 302) recorded to have died of different types of TB (e.g., pulmonary TB, miliary TB, peritoneal TB, and skeletal TB). The same observations were made on a control (non-TB (NTB)) group consisting of randomly selected individuals (N = 302) from the Terry Collection, identified to have died of causes other than TB (e.g., other infectious diseases, cardiovascular problems, cancer, and external causes, such as car accident, suicide or homicide).…”

Section: Plos Onementioning

confidence: 99%

Tracking down the White Plague. Chapter two: The role of endocranial abnormal blood vessel impressions and periosteal appositions in the paleopathological diagnosis of tuberculous meningitis

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Although endocranial abnormal blood vessel impressions (ABVIs) and periosteal appositions (PAs) have been considered as paleopathological diagnostic criteria for tuberculous meningitis (TBM) based on findings of previous studies, they are not pathognomonic for tuberculosis (TB). Therefore, their utilization in the paleopathological practice can be questioned, especially in consideration that most of the previous studies were not performed on identified skeletal collections but on osteoarchaeological material and did not include statistical data analysis. To fill the aforementioned research gap, for the first time, a macroscopic investigation was conducted on identified pre-antibiotic era skeletons from the Terry Collection. A sample set of 234 individuals who died of TB (TB group) and 193 individuals who died of non-tuberculous causes (NTB group) were examined. The frequency of ABVIs and PAs, as well as other probable TB-related lesions was recorded. To determine the significance of difference (if any) in the frequencies of ABVIs and PAs between the two groups, χ 2 testing of our data was performed. We found that ABVIs, PAs, and their co-occurrence with each other and with other probable TB-related lesions were more common in the TB group than in the NTB group. In addition, the χ 2 comparative frequencies of ABVIs and PAs revealed a statistically significant difference between individuals who died of TB and individuals who died of NTB causes. Our findings strengthen those of previous studies that ABVIs and PAs are not specific to TBM but can be of tuberculous origin. Therefore, they do have a diagnostic value in the identification of TB in human osteoarchaeological material, especially when they simultaneously occur with other probable TB-related lesions. Their prudent utilization provides paleopathologists with a stronger basis for diagnosing TB and consequently, a more sensitive means of assessing TB frequency in past human populations.

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“…Hershkovitz et al (), Pálfi, Bereczki, Ortner, and Dutour (), and more recently Spekker () have convincingly discussed at length the link between tuberculosis and SES, noting the high prevalence of these lesions young individuals that reportedly died from this disease. It is worth noting that in the cases reported here, one (the individual from Petit‐Chasseur) does exhibit a circular lesion with bone erosion and edge remodelling, the appearance of which is congruent with lytic bone lesions seen in children suffering from tuberculosis (Pálfi et al, ; Schultz, ).…”

Section: Discussionmentioning

confidence: 99%

Cases of serpens endocrania symmetrica in young individuals from Neolithic Western Switzerland: Description and interpretation

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Dutour

Desideri

et al. 2020

Intl J of Osteoarchaeology

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Endocranial lesions known as serpens endocrania symmetrica (SES) appear relatively frequently in the paleopathological record, but their significance often goes undiscussed. For the past decade, however, research has proved conclusively that their presence is an indicator of illnesses within the corpus. As such, cases found in the archaeological record can provide clues as to the kinds of diseases that prehistoric populations endured. We report four cases of young individuals from Neolithic Western Switzerland bearing SES on their craniums and discuss the implications of such findings in terms of the paleopathological profile of these populations. The following article provides documentation for each case as well as a differential diagnosis including tuberculosis, meningitis, trauma, and metabolic conditions such as scurvy. These four individuals represent the oldest cases of such lesions described for this region.

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Evaluation of endocranial bony changes in relation to tuberculosis in the Robert J. Terry Anatomical Skeletal Collection (Washington, DC, USA)

Cited by 8 publications

References 30 publications

Tracking down the White Plague: The skeletal evidence of tuberculous meningitis in the Robert J. Terry Anatomical Skeletal Collection

Tracking down the White Plague: The skeletal evidence of tuberculous meningitis in the Robert J. Terry Anatomical Skeletal Collection

Tracking down the White Plague. Chapter two: The role of endocranial abnormal blood vessel impressions and periosteal appositions in the paleopathological diagnosis of tuberculous meningitis

Cases of serpens endocrania symmetrica in young individuals from Neolithic Western Switzerland: Description and interpretation

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