Trephine

Surgical intervention involving the removal of a circular piece of bone from the skull

Trephination, also known as trepanation, is a surgical intervention in which a circular section of the skull is removed. This procedure has been used since ancient times and is one of the oldest known surgical practices.

History

Trephination dates back to prehistoric times, with evidence found in Neolithic skulls. The practice was widespread across various cultures, including those in Europe, Africa, and South America. The reasons for trephination in ancient times are not entirely clear, but it is believed to have been performed to treat head injuries, epilepsy, mental disorders, and to release evil spirits.

Ancient Greece

In Ancient Greece, trephination was described by Hippocrates, who provided detailed instructions on the procedure. The Greeks used a tool called a trephine, which was a circular saw-like instrument, to perform the operation. The procedure was considered a last resort for treating head trauma and intracranial pressure.

Ancient Greek surgical instruments, including a trephine.

Middle Ages

During the Middle Ages, trephination continued to be practiced in Europe. It was often performed by barber-surgeons and was used to treat skull fractures and head injuries. The procedure was risky and often led to infection and death.

Modern Era

In the modern era, trephination has evolved into more sophisticated procedures such as craniotomy and burr hole surgery. These procedures are used to treat subdural hematomas, brain tumors, and other conditions that require access to the brain.

Procedure

The procedure of trephination involves the use of a trephine to cut a circular hole in the skull. In ancient times, this was done without anesthesia, and the patient was often restrained. The trephine was rotated manually to cut through the bone, and the circular piece of bone was removed to expose the dura mater.

Dr. John Clarke performing a trepanning operation.

Cultural Significance

Trephination has held various cultural significances throughout history. In some cultures, it was believed to have spiritual or ritualistic purposes. Skulls with trephination holes have been found in archaeological sites, often showing signs of healing, indicating that some individuals survived the procedure.

Related pages

• Craniotomy
• Neurosurgery
• History of surgery

References

• Broca, P. (1876). "On the trephined skulls of prehistoric times". Journal of Anthropology.
• Faria, M. A. (2013). "Trepanation: History, discovery, theory". Surgical Neurology International.
• Verano, J. W. (2003). "Trepanation in prehistoric South America: Geographic and temporal trends over 2,000 years". Neurosurgical Focus.