Neurosurgical aspects of trepanations from Neolithic times

Trepanation of the cranial vault is the oldest known surgical procedure and has often been reported in the literature. We present two skulls with trepanations from Neolithic excavations in southwestern Germany. One skull exhibits a healed fracture in association with the trepanation. Both skulls show clear signs of healing without evidence of osteolytic inflammatory reaction. We discuss conditions relating to survival from trepanation in Neolithic times and some potential complications such as intraoperative bleeding and wound infection, in the context of modern neurosurgical knowledge. We conclude that neolithic skull surgery was probably mainly extradural. Copyright © 2006 John Wiley & Sons, Ltd.     

Trepanation in Italy: A Review

This paper reviews and discusses cases of skull trepanation in ancient Italy on the basis of information provided by the literature. A total of 54 individuals from 43 different Italian archaeological sites were found to have evidence of trepanation. The analysis of evidences of trepanation in Italy has demonstrated that no differences can generally be perceived between the trepanned individual and the social context of the burial, leading to exclude a special role of the former within the group. Trepanation in Italy covers a time span of approximately 7000 years, the most ancient cases dating back to the fifth millennium bc and the most recent to the 18th–19th centuries ad . The geographic distribution appears quite homogeneous, with a prevalence of cases in Central Italy and abundant evidence from prehistoric Sardinia. The majority of individuals show a single trepanation, whereas others present skulls with multiple holes. Trepanation in Italy was reserved to adult individuals, except for some rare cases, and shows a relevant preponderance for the male sex. The most diffused technique is scraping; cutting and drilling are less attested, especially as unique techniques for trepanation, but they were used more frequently in combination with scraping. Trepanation could in some cases be hypothesised as therapeutic intervention for the treatment of a traumatic wound or of other pathologies, whereas in other cases, a number of evidences are attested of trepanation performed as probable ritual intervention or as experimental surgery; in the remaining cases, the reasons for trepanation are unclear or not determinable. A high percentage of long‐term healing associated with trepanation has been evidenced. Copyright © 2017 John Wiley & Sons, Ltd.     

Ante Mortem Cranial Trepanation in the Late Bronze Age in Western Siberia

We report a case study of cranial trepanation in a male subject 30 to 40 years of age from the Nefteprovod II burial ground in the Anzhevsk archeological site. This burial dates back to the Late Bronze Age, in particular the Karasuk culture located in the Minusinsk Basin on the Yenisei River and on the upper reaches of the Ob River. The left parietal bone had an opening with evident signs of bone healing, as well as signs of inflammatory reaction from both bone plates of the calvarium. The strongest signs of inflammation were located around the trepanation opening at the exocranium, suggesting that it occurred after, rather than before, the operation. Although trepanation was the main cause for the development of the changes noted in the preceding texts, there are no reasons to believe that the subject died from complications arising from infection after trepanation. The patient survived and later died for reasons that may never be determined. Medical necessity was the most likely justification for trepanation. Immersion in altered states of consciousness may also have been a necessary part of the trepanation process as a mode of sedation, along with other shamanic practices, such as consumption of psychotropic substances or ecstatic dance. These data, together with reports of other ante mortem burials, raised questions about the application of anaesthesia and possible techniques of cranial trepanation. These issues and possible postoperative complications are discussed in the following text. Copyright © 2016 John Wiley & Sons, Ltd.     

A scientific analysis of cranial trepanation from an Early Iron Age cemetery on the ancient Silk Road in Xinjiang,China

This study uses multiple scientific methods to analyse a case of trepanation from a cemetery located at the westernmost point along the ancient Silk Road in China dating back to the Early Iron Age. The skull of interest belonged to a middle-aged male; the opening is located on the left posterior side of the skull in the occipital bone. Computer tomography (CT) and microscopic observation show that the incision was unhealed, indicating an immediate death either during or after the operation. The procedure of trepanation might have been used to treat a depressed fracture from inflicted trauma on the individual’s right parietal bone, suggesting the presence of surgical trepanation in early Western China.     

A review of trepanations in Anatolia with new cases

In this study, trepanations in ancient Anatolia were discussed from a historical perspective. Trepanations were studied in respect to temporal and spatial distribution, sex and age distribution, techniques and reasons, completeness, healing and number of holes. Forty individuals from 23 different Anatolian settlements are identified to have undergone trepanations. Cranial trepanations in Anatolia show a distribution over a period of 10 000 years ranging from the Aceramic Neolithic period to the Late Ottoman period and spread to whole Anatolia. The greater majority of the individuals had single trepanation orifices while only four individuals were identified with multiple holes. It is observed that the surgical procedure was predominantly carried out on males in Anatolia. Main techniques of trepanations used in Anatolia are drilling and cutting. Early cases of trepanation were made by drilling; however, this technique has been used for cranial surgery until the Ottoman period. Scraping and rectangular sawing techniques first applied in the Early Bronze Age. The boring‐and‐cutting technique was only applied in the Iron Age. More than half of the trepanations practiced due to cranial trauma. Training and treatment besides of cranial trauma are also considered as likely causes of trepanations in Anatolia. It is concluded that trepanation techniques are similar to South America and the Mediterranean region rather than Europe. Copyright © 2010 John Wiley & Sons, Ltd.     

Short Report: Evidence of Trepanation on a Female Individual from the Middle Bronze Age Necropolis of Casas Velhas (Melides,Portugal)

Recent reanalysis of the human remains unearthed from the grave cists of the necropolis of Casas Velhas (Melides, Portugal) from the Southwest Iberian Middle Bronze Age, with a minimal number of 25 individuals (23 adults and 2 non‐adults), allowed relevant anthropological data. This culture, although widespread in southern Portugal and nearby areas of southwest Spain in the Middle Bronze Age, is characterized by the paucity of preserved human remains and thus the anthropological knowledge of these human populations. The adult female skeleton exhumed from cist 30, the last interment of this double burial, exhibit a complete perforation on the right parietal bone. The aim of this paper is to present and discuss this defect, which most probable diagnosis is trepanation. The hole is oval shape exhibiting long term healing. A shallow remodelled area is visible around the defect, which suggests scraping method. No complications or evident reasons for the intervention were observed. In terms of mortuary practices no clear distinction was observed between this individual and others from this cemetery. The features of this trepanation fit in the major points summarized by Silva ( 2003 ) for prehistoric Portuguese trepanation. These data sustain the existence of an old tradition of this procedure is this region of Iberia, present, at least, since the Middle Neolithic. Copyright © 2016 John Wiley & Sons, Ltd.     

HLO1‐south: An Early Neolithic site in Wadi al‐Hilo (Sharjah,UAE)

Site HLO1 (Sharjah, UAE), situated in a particularly favourable geographical position, has provided an extraordinary range of anthropogenic radiocarbon dates, spanning before 8000 to Zero BCE. The Neolithic is represented by finds from the eighth to the fifth millennium BCE. Apart from the dated fireplaces, however, there are almost no typical artefacts of this period. Small stone structures appear to have been early Neolithic graves. A middle Neolithic grave consisted of a large rounded stone heap which was reused as a grave during the Late Bronze Age. The site is interpreted as a campsite of nomadic herders, used throughout the Neolithic period. After a break in the fourth millennium BCE, the site became a Bronze Age smelting site which continued to be settled until the Late Iron Age.     

Spatial dimensions increase the effect of cultural drift

The transition from hunter-gathering to agriculture (Neolithic) spread gradually across Europe from the Southeast. A reduction in cultural diversity of crop farming practices has been previously observed by comparing pre-LBK Neolithic sites in Greece and the Balkans (dated about 8500 yr BP) to LBK Neolithic sites in Central Europe (dated about 7000 yr BP). The decrease in crop diversity is statistically significant even when considering only the species less likely to have been subject to smaller productivity due to climatic factors (reductions in growing season, temperature, daylight, etc.). This reduction in cultural diversity has not been explained previously. In this paper we show that spatial drift, which occurred on the front of the advancing wave of pioneer settlements, can explain the observed loss of diversity during the LBK range expansion. Our results suggest that spatial dimensions can have a relevant effect also in other case studies in which cultural drift is important.     

Late Mesolithic burials at Casa Corona (Villena,Spain): direct radiocarbon and palaeodietary evidence of the last forager populations in Eastern Iberia

Current knowledge about the Mesolithic–Neolithic transition in the Central and Western Mediterranean European regions is deeply limited by the paucity of Late Mesolithic human osteological data and the presence of chronological gaps covering several centuries between the last foragers and the first archaeological evidence of farming peoples. In this work, we present new data to fill these gaps. We provide direct AMS radiocarbon dating and carbon (δ¹³C) and nitrogen (δ¹⁵N) stable isotope analysis were carried out on bone collagen samples of two single burials from the recently discovered open-air Late Mesolithic site of Casa Corona (Villena, Spain). The results shed new light on the chronology and subsistence patterns of the last Mesolithic communities in the Central Mediterranean region of the Iberian Peninsula. Radiocarbon results date the human remains and funerary activity of the site to 6059–5849 cal BC, statistically different from other Late Mesolithic sites and the earliest Neolithic contexts, and bridging the 500 yrs chronological gap of the Mesolithic–Neolithic transition from the area. Isotopic evidence shows that diet was based on terrestrial resources despite the proximity to the site of lagoon and marine ecosystems. This and previous isotope studies from the region suggest a lower reliance upon marine resources than for Atlantic and Cantabrian sites, although intra-regional patterns of neighbouring Mesolithic populations exhibit both fully terrestrial diets and diets with significant amounts of aquatic resources in them. We hypothesize that in the Central Mediterranean region of Spain the Late Mesolithic dietary adaptations imposed structural limits on demographic growth of the last foragers and favoured rapid assimilation by the earliest Neolithic populations.     

The Siege of Colchester

Archaeological excavations in advance of quarrying at Cheviot Quarry, Northumb. have produced important evidence for Neolithic, Late Bronze Age and Dark Age settlements. Neolithic pit features containing domestic midden material including broken pottery, lithics and cereal grains from two distinct parts of the quarry have provided evidence for what is interpreted as settlement and subsistence activity from the Early and Later Neolithic periods. Together with the Neolithic remains from the nearby sites at Thirlings and those recently excavated at Lanton Quarry, it provides evidence for significant, and perhaps intensive, settlement on the sand and gravel terraces of the Milfield Plain throughout the Neolithic. Indeed, these sites provide the precursors to the better known ceremonial and henge complex located nearby which probably dates to the Beaker period. Radiocarbon determinations associated with the full sequence of Neolithic pottery have been obtained from Cheviot Quarry and analysis of the residues adhering to the ceramics has provided some of the earliest evidence for dairy farming in the region, as well as information relating to other dietary and subsistence practices. Two substantial roundhouses with porches, internal hearths and pits containing domestic refuse, provide the first evidence for Late Bronze Age lowland settlement in the region. The botanical macrofossil and faunal evidence, together with the pottery residues, show clear evidence for arable and pastoral activity in a small, unenclosed farming settlement. A detailed programme of radiocarbon dating and the application of Bayesian modelling has shown that these two buildings are contemporary and date to the tenth century cal. BC. In addition to this prehistoric archaeology, three Dark Age, rectangular, post-built buildings were also discovered on the site and have been radiocarbon dated to the fifth or early sixth century cal. AD. These substantial, although heavily truncated, structures are thought to represent the homesteads of a small farming community, although the lack of material culture makes understanding their use and cultural attribution problematic. Because of their early date these buildings could have belonged to either post-Roman British inhabitants or perhaps early Anglo-Saxon mercenaries or settlers. A reconstruction of one of these buildings has been built close to the site at the nearby Maelmin Heritage Trail where it can be visited by the public.     

Obsidian provenance analyses at Göytepe,Azerbaijan: Implications for understanding Neolithic socioeconomies in the southern Caucasus

This study presents a provenance analysis of the Neolithic obsidian assemblages from the early to mid‐sixth millennium bc settlement at Göytepe, Azerbaijan. The study is unique in that (1) it involves a complete, non‐selected obsidian assemblage (901 artefacts) from one particular area of the site; (2) the material is derived from a well‐stratified sequence of 10 securely radiocarbon‐dated architectural levels; and (3) the use of an extraordinarily wide range of sources (more than 20) was identified by provenance analysis using energy‐dispersive X‐ray fluorescence. The results reveal a previously unknown diachronic change in obsidian use in the region, suggesting the occurrence of significant socioeconomic changes during the Late Neolithic of the southern Caucasus.     

Transition from hunting to animal husbandry in Southern,Western and Eastern Finland: new dated osteological evidence

The beginning of animal husbandry in Finland is one of the most debated topics in Finnish archaeology. For this study a total of 69 bone materials from archaeological sites in Southern, Western and Eastern Finland, dating from the Middle Neolithic to the Early Metal Period, were analysed: 52 represented identifiable animal bones. These data were complemented with those from previously analysed bone materials. A total of 19 domestic animal bones were radiocarbon-dated to determine their connection with a particular cultural period. However, 13 of them proved to belong to the historical and not the prehistoric period, emphasizing the importance of radiocarbon-dating and context awareness when interpreting prehistoric bone materials. Among the radiocarbon-dated material were the oldest dated sheep, cattle and horse bones in Finland. The oldest radiocarbon-dated domestic animal bone in Finland, from sheep or goat, derives from the Late Stone Age Kiukainen Culture site, while cattle and horse bones date to the Bronze Age. This is later than expected. However, the available material does not exclude the possibility that some animal husbandry was practised in Finland earlier. Nevertheless, domestic animal bones are rare in samples dated to the cultural periods studied, while hunting and fishing represented important subsistence activities.     

Imaging Evaluation of Skull Trepanation Using Radiography and CT

Cranial surgery as practised by the prehistoric and present-day traditional medicine man is the oldest known and one of the highest surgical achievements in the history of medicine. This study examines morbidity and mortality of this ancient surgical procedure by re-examining and reviewing reports of 71 completely trepanned skulls from pre-Columbian Peru by three techniques: gross visual observation and palpation; radiography; and CT. The specimens are located in the San Diego Museum of Man and are part of the Hrdlicka collection. Clear distinction can be made by visual observation between skulls with bone regeneration and those without; that is, between patients who survived long enough to allow bone healing and those who died immediately or within a few days of the operation. 64.8 per cent of skulls had complete healing, 12.7 per cent had partial healing and 22.5 per cent had no evidence of healing. Thus, a post-operative survival rate of 77.5 per cent is noted by gross examination. The meaning of completely trepanned skulls with no evidence of healing is questionable, however, some unhealed skulls may represent post-mortem trepanation, suggesting a lower surgical mortality. Both radiography and CT scan demonstrate with considerable accuracy the presence or absence of new bone formation on trepanned skulls. One skull demonstrated evidence of partial bone healing by CT and radiography but not by our gross examination or by that of some anthropologists. Evidence of osteomyelitis was illustrated by CT scan but not by radiography.     

Production and use of birch bark tar at the Neolithic pile-dwelling of Palù di Livenza (North-Eastern Italy) revealed by X-ray computed micro-tomography and synchrotron Fourier-transform infrared spectroscopy

Recent excavations at Palù di Livenza (northeastern Italy) revealed a multiphase Neolithic pile dwelling dated between ca. 4,300/4200 and 3,600 cal BC. Three lumps with teeth imprints and a larger amorphous piece from the Late Neolithic layers have been studied by X-ray computed micro-tomography (microCT) and synchrotron Fourier-transform infrared spectroscopy (FTIR). FTIR spectra match well that of birch bark tar and microCT of the larger piece has revealed a rolled-up structure likely corresponding to bark rolls. The lumps of birch pitch were probably chewed to soften the tar prior to be used as hafting adhesive or therapeutic substance. The rolled-up inner structure of the larger piece and the remains of birch bark tar and abundant charcoals on its surface suggest it probably corresponds to a rare waste product from allothermic tar production.     

Early farming in hordaland,western Norway. Problems and approaches in archaeology and pollen analysis

This article discusses the evidence of farming settlements in Neolithic times in the county of Hordaland, in western Norway, and possible ways for future research to establish the introduction of a farming economy, with its cultural and ecological implications.

Using distribution maps, Bakka demonstrates how the people of the mainly hunting and fishing sub‐Neolithic dwelling‐place culture of the Middle Neolithic period preferred a coastal area of habitation, while the find groups of Neolithic artifacts are generally to be found in those areas more suitable for farming. This change of habitat is interpreted as evidence of a general change in economic structure, with a greatly increased emphasis on agriculture.

Kaland discusses the Sub‐Boreal history of vegetation in Hordaland as revealed by pollen analysis. The earliest phase of agriculture in the pollen diagrams is dated in relation to the pollenanalytical leading horizons, the shore‐line displacement, radiocarbon measurements and the archaeological chronology. He puts forward the working hypothesis that in the sub‐Neolithic culture of the Middle Neolithic period some animal husbandry may have been practised in zone VIII b as a supplementary means of livelihood, and that this was followed by a phase of cereal growing in zone VIII c. The Late Neolithic culture appears to be responsible for this more intensive mixed farming, and this corresponds to the archaeological evidence of the introduction of cereal cultivation, which demands the better‐soils of the later farming land.     

Trepanations from Oman: A case of diffusion?

Trepanations have been described from various locations around the world leading to a suggestion that this is a cultural practice that has widely diffused from one or two centres ( 1 ). In the UAE the earliest trepanations date to the Neolithic, significantly earlier than trepanations in surrounding areas. The discovery of at least two crania in Oman, dating apparently to the early third millennium and resembling in technique and placement trepanations from north India may be evidence of the diffusion of a therapeutic practice from the Gulf to the subcontinent. However, the lack of any trepanation among the numerous contemporary skeletons from Bahrain suggests that any diffusion has distinct limits and that, as anthropological work from the South Pacific ( 2 ) indicates, practices like trepanation are often heavily embedded in broader, culturally located explanatory models.     

Evidence of interpersonal violence at the Chalcolithic village of Shiqmim (Israel)

Three circumscribed depressed fractures were found on the skull of an adolescent boy recovered from a primary intramural burial at the Chalcolithic site of Shiqmim, northern Negev, Israel dated to (∼4500–3200 BCE). The fractures were located on the left side and back of the skull. They are circular in outline and have sharp margins containing numerous small bone fragments. These indicate that the skull was fractured when the bone was still fresh and were the probable cause of death. The location of the fractured areas is typical of blows inflicted by a right‐handed individual in face‐to‐face conflict. The size and shape of the fractures, suggests that they were inflicted by a blunt instrument, possibly a mace head. The absence of any signs of healing or infection indicates that all fractures occurred within a short space of time and resulted in death. Neither biological characteristics nor burial pattern show any unique features that distinguish this individual from others recovered at this site. Copyright © 2003 John Wiley & Sons, Ltd.     

Ais Giorkis: An unusual early Neolithic settlement in Cyprus

Abstract

For over a century, archaeologists have been intrigued by the inception of food production and sedentary lifeways, the so-called “Neolithic Revolution.” Research focused on the Near Eastern and Anatolian mainlands has documented some of the earliest Neolithic cultures known. The adjacent Mediterranean islands were generally believed to have been late recipients of Neolithic economies. Recent research challenges this by establishing both Late Epipalaeolithic and early Neolithic occupations on Cyprus. Ais Giorkis contributes to this revision. It is an early Neolithic site (ca. 7500 cal b.c.) in the uplands, unlike most contemporary sites, which are near the coast. Ais Giorkis is more complex than originally believed, containing unusual architecture, abundant and sophisticated artifacts, and some of the oldest directly dated domesticated plants in the Near East. It also has a faunal assemblage that includes small numbers of cattle bones, previously undocumented before the Bronze Age, but now shown to be present at three early Neolithic sites.     

Non‐osseous calcaneonavicular coalition in the Portuguese prehistoric population: report of two cases

This paper reports articular surface defects detected in three foot bones. These were exhumed from Portuguese collective burial places, Hipogeu de São Paulo II (artificial cave, Almada) and Necrópole da Serra da Roupa (shelter, Columbeira) dated to the Late Neolithic and Chalcolithic periods. Other aetiologies were presented, but non‐osseous calcaneonavicular coalition proved to be the most probable explanation for the unusual morphology detected in two calcanei and one navicular bone. Copyright © 2005 John Wiley & Sons, Ltd.     

The spread of Neolithic plant economies from the Near East to northwest Europe: a phylogenetic analysis

Phylogenetic techniques are used to analyse the spread of Neolithic plant economies from the Near East to northwest Europe as a branching process from a founding ancestor. The analyses are based on a database of c. 7500 records of plant taxa from 250 sites dated to the early Neolithic of the region in which they occur, aggregated into a number of regional groups. The analysis demonstrates that a phylogenetic signal exists in the data but it is complicated by the fact that in comparison with the changes that occurred when the crop agriculture complex expanded out of the Near East, once it arrived in Europe it underwent only limited further changes. On the basis of the analysis it has been possible to identify the species losses and gains that occurred as the complex of crops and associated weeds spread and to show the influence of geographical location and cultural affinity on the pattern of losses and gains. This has led to consideration of the processes producing that history, including some reasons why the dispersal process did not produce a perfect tree phylogeny, as well as to the identification of some specific anomalies, such as the unusual nature of the Bulgarian pattern, which raise further questions for the future.