The skull is affected by a left temporal bone fracture healed with loss of bony fragments. The squama appears slightly depressed and, radiographically, shows two main lines of fusion radiating from the lower part of the bone where three lacunae can be observed. On the parietal bone, immediately above the area affected by trauma, the skull exhibits two regularly curved grooves. One, about 3 cm long,  starts from the posterior border of the squamosal suture; the other, 9 cm long, runs above the first and reaches the coronal suture. Remodelling of compacta indicates that the two incisions were made during life. These changes indicate that this individual suffered a violent blunt trauma that broke the temporal bone. No further evidence of injuries have been observed in the remaining material. The trauma, possibly resulting from a blow inflicted frontally by using a blunt instrument held with the right hand, was not lethal but required surgical treatment and care. We suggest that the skull was incised above the injured area with a pointed tool in order to isolate and detach the soft tissues overlying the fracture, remove isolated bone fragments and keep the wound clean. Considering the antiquity of the skull, the instrument used could have been made of copper, flint, or obsidian (a vitreous material of volcanic origin). The shorter incision was probably a first attempt interrupted for contingent reasons, possibly because it was too low. This case provides the first evidence of such a treatment of an injured skull and proves once more the therapeutic knowledge of prehistoric populations, emphasizing their ability to modulate surgical procedures according to specific needs.

, Portale Italiano di Paleopatologia. UniversitÓ di Pisa. Direttore prof. Gino Fornaciari"> An unusual surgical treatment of the skull following trauma during the Copper Age (IV millennium B.C.) in Italy

An unusual surgical treatment of the skull following trauma during the Copper Age (IV millennium B.C.) in Italy

di Vincenzo Formicola, Sonia Cammellini, Davide Caramella, Angiolo Del Lucchese, Gwenaelle Goude, Mariasilvia Saccone, Gino Fornaciari

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The skull is affected by a left temporal bone fracture healed with loss of bony fragments. The squama appears slightly depressed and, radiographically, shows two main lines of fusion radiating from the lower part of the bone where three lacunae can be observed. On the parietal bone, immediately above the area affected by trauma, the skull exhibits two regularly curved grooves. One, about 3 cm long,  starts from the posterior border of the squamosal suture; the other, 9 cm long, runs above the first and reaches the coronal suture. Remodelling of compacta indicates that the two incisions were made during life. These changes indicate that this individual suffered a violent blunt trauma that broke the temporal bone. No further evidence of injuries have been observed in the remaining material. The trauma, possibly resulting from a blow inflicted frontally by using a blunt instrument held with the right hand, was not lethal but required surgical treatment and care. We suggest that the skull was incised above the injured area with a pointed tool in order to isolate and detach the soft tissues overlying the fracture, remove isolated bone fragments and keep the wound clean. Considering the antiquity of the skull, the instrument used could have been made of copper, flint, or obsidian (a vitreous material of volcanic origin). The shorter incision was probably a first attempt interrupted for contingent reasons, possibly because it was too low. This case provides the first evidence of such a treatment of an injured skull and proves once more the therapeutic knowledge of prehistoric populations, emphasizing their ability to modulate surgical procedures according to specific needs.


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