Trepanning

The intentional perforation of the cranium exposes the dura mater to treat health problems related to intracranial diseases or release pressured blood buildup from an injury.

[6] The primary theories for the practice of trepanation in ancient times include spiritual purposes and treatment for epilepsy, head wound, mental disorders, and headache, although the latter may be just an unfounded myth.

Although the abdominal wall does not contain bone, the use of the word trephine in this context may relate to the round excised area of skin being similar in shape to a burr hole.

[9] More than 1,500 trephined skulls from the Neolithic period (representing 5–10% of all cranial remains from that era) have been uncovered throughout the world – from Europe, Siberia, China and the Americas.

This was a widespread tradition, illustrated in pre-Columbian art that occasionally depicts rulers adorned with or carrying the modified skulls of their defeated enemies, or of the ritualistic display of sacrificial victims.

Several Mesoamerican cultures used a skull-rack (known by its Nahuatl term, tzompantli), on which skulls were impaled in rows or columns of wooden stakes.

[citation needed] The earliest archaeological survey published of trepanned crania was a late 19th-century study of several specimens recovered from the Tarahumara mountains by the Norwegian ethnographer Carl Lumholtz.

Instead, the pre-Columbian Maya apparently used an abrasive technique that ground away at the back of the skull, thinning the bone and sometimes perforating it, similar to the examples from Cholula.

However, in 2007, Han and Chen from the Institute of Archeology, Chinese Academy of Social Sciences looked at six trepanned skulls spanning between the Neolithic period through the Bronze and Iron Ages (c. 5000–2000 years ago) found in five different locations.

Meanwhile, the oldest trepanned skull (M382) analysed by Han and Chen was radiocarbon dated to around 5,000 years ago and discovered at the Fuija site in Guangrao, Shandong.

[20] Additionally, bone regeneration and smooth edges suggest that the subject recovered from the surgery and lived a relatively long time afterward.

The 3,600-year-old perforated skull of a mummified female dating to 1615 BCE was found in the Xiaohe tomb in China's Xinjiang Uygur Autonomous Region.

[5] In the graveyards of pre-Christian (Pagan) Magyars, archeologists found a surprisingly high frequency (12.5%) of skulls with trepanation, although more than 90% only partial (these served probably ritual purposes).

[9] The prefrontal leucotomy, a precursor to lobotomy, was performed by cutting a trephine hole into the skull, inserting an instrument, and destroying parts of the brain.

[9] After the retrieval of some skulls from the Neolithic era that showed signs of trepanation, in the nineteenth century, the false belief that these holes were drilled for the treatment of headaches or other neurological disorders started spreading.

During the 1870s, the French anthropologist and physician Paul Broca found several European and South American children's skulls dating to the Neolithic age that were perforated surgically.

Since no signs of fractures that could justify this complex procedure to relieve trauma were found, a debate emerged around why these children were subjected to trepanation while they were still alive.

Osler misinterpreted Broca's words, and added other conditions such as "infantile convulsions, headache and various cerebral diseases believed to be caused by confined demons."

Osler's theory was seen as particularly palatable by other armchair anthropologists, who were fascinated by the idea that folk traditions and/or myths could be linked with the treatment for common conditions such as migraine.

In Africa and Europe, not only this procedure was performed for spiritual reasons, but also the discs made of cranial bones were commonly used as shield from demons and evils.

[20] This tells about connection of cranial surgery to religion; there was conception that open hole in head contributes to communication with god and souls of dead people.

On the other hand, it was thought that cerebral disorder arise from the loss of spiritual image in ancient Peru, illness developed after being separated from body.

[30] In ancient times, trepanation instruments were less complex, and were commonly made out of flint, obsidian, or harder material such as stone knives, and later with metal such as bronze and copper.

[33] A neurosurgeon can perform the procedure safely, although it comes with severe repercussions such as direct or indirect perioperative complications, which include increased damage to the brain, infection, blood loss, hemorrhage, and potentially death due to the trauma as the skull's protective covering is compromised.

A prominent proponent of the modern view is Peter Halvorson, who drilled a hole in the front of his own skull to increase "brain blood volume".

At last!Feilding also performed a self-trepanation with a drill, while Mellen shot the operation for the short film Heartbeat in the Brain, which was long thought to have been lost.

In 2000, two men from Cedar City, Utah, were prosecuted for practicing medicine without a license after they performed a trepanation on an English woman to treat her chronic fatigue syndrome and depression.

[44] In 2023, Michael Raduga, a Russian lucid dreaming researcher, performed self-neurosurgery that included trepanation, electrode implantation, and electrical stimulation of the motor cortex.

One of the reasons of distinction in variations of healing process is difference of surgical methods such as “scraping” or “grooving” that might alter the angle of the edge.

[49] By the 20th century, the ancient practice of trepanning evolved into procedure of bone marrow biopsy, which became vital for identifying illnesses including anemia, leukomia, lymphoma, and tuberculosis.