I Need a Trepanning Like I Need a Hole in the Head

Painting by Hieronymous Bosch

Periodically anthropologists or archaeologists will unearth a prehistoric human skull that has a hole in it. The hole is not damage after the person’s death. We know this because it shows signs of healing around the edge of the hole. The person was alive when the hole was made and lived long enough afterwards for the healing process to begin.

The practice is called trepanning. (Sometimes referred to as trephination, trephining or making a burr hole.) It was a surgical treatment in which a hole is drilled or scraped into a person’s skull so that the dura mater (a thick membrane found directly under the skull or in the spinal cord) is exposed. It was done to heal the person from an ailment thought to be caused by pressure in the brain.

The practice was not rare in prehistoric times. A burial site in France, which dates back to about 6500 BC, contained 120 skulls, 40 of which had undergone the process. Other examples from this period exist.

The practice was also carried out in Pre-Columbian Meso-America but it is more difficult to determine how common it was because some of these cultures also practiced the mutilation of skulls kept as trophies. If there is no indication of healing we can’t know if the hole was the cause of death or made shortly afterwards.

The ancient Greeks and medieval Europeans also practiced trepanning. Hippocrates (c.460-c.370 BC), of Hippocratic Oath fame, gave instructions for performing the process. Of the eight skulls found in Germany of the 6th to 8th centuries AD, seven showed signs of healing. Of the uncovered skulls of pre-Christian Magyars (Hungary), about one-eighth of them had evidence of trepanning.

In the Middle Ages and Renaissance trepanning was thought to heal seizures and, oddly, fractured skulls from accidents.

Before you think that those bad old days are passed, doctors today still perform the operation from time to time but, with a major difference. They try to replace the cut away portion as soon as possible. Called a craniotomy, it is done to access the brain. However, the removed portion is not always replaced. In that case it is called a craniectomy.

© 2017 Gary J. Sibio. All rights reserved.