Trepanning

When does your story take place? And where? I read that survivors sometimes wore the removed bone around the neck as a good luck charm. Not early Europeans, before then.

<-- my personal anti-trepanning device

Depending on how it is done there may not be a piece of bone, just some dust. Modern trepanners normally drill.

Oh they definitely leave the hole. Otherwise there is no change in pressure. Also you can see it in how the skulls have partially healed closed in archeological specimens.

It is, but there's evidence of bone healing. . . odd. Hey, you probably saw this but just in case you haven't, www.rcpe.ac.uk/journal/issue/journal_40_2/tullo.pdf‎

Discusses trepanning in ancient Roman times.

http://www.medscape.com/viewarticle/563097_2

http://www.princeton.edu/~cggross/trepanation.pdf

I p.m.'d you, Little A, in the interest of science.

Letting the evil spirits out did require leaving a hole, at least as documented in some archeological cases (as veinglory mentioned). If the bone piece is removed carefully, the dura mater will still be intact, and that is a very though connective tissue sheath around the brain, so the brain itself will not be directly exposed. I don't know if there is any evidence for how deep the dissection went beyond bone. Those evil spirits can be devilish to deal with.

As for the fate of the bone fragment--you can have full license to have your characters deal with it in any way that serves the story.

Little Anonymous Me said:

Creepy to think of nothing but some skin between the world and your brain, isn't it?

Click to expand...

The skull only covers half the brain. The rest is exposed to lots of easily punctured bits.

As I understand trepanning from back in the Roman/Galen era, the point of the surgery was to leave a hole with no bone so there wouldn't be any pressure on the brain from swelling, etc. That's what the real killer was for many of those traumas Galen worked on.

There is a decent medical text that covers Galen's teachings but I can't remember it off the top of my head nor find in it a basic search. Probably any decent teaching hospital would have it, and others, available in the library or online.

Jeff

A friend of mine was talking about doing a presentation on historical treppaning practices for a historical reenactment group we are both in.

He started joking about doing a demo and using me as the model. He said it might help with my sinus headaches.

I replied, "Yeah, I need to be treppaned like I need a hole in the head."

One of few times I actually thought of the comeback right then, instead of much later...

I thoroughly enjoy the notion of pulling off a square chunk and making it into a necklace.

I once heard an interesting argument between a couple of neurosurgeons about whether it's better or not to remove or replace a bit of bone and it basically depended on whether or not the piece of bone has likely been devascularized. In such a case it is more a risk of osteomyelitis than it is a benefit as brain protection. It would take a careful dissection by someone experienced and depend on the size and location of the hole to open a window without devascularizing that fragment.