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.     

Endocranial lesions in non‐adult skeletons: understanding their aetiology

Reactive new bone on the endocranial surface of the skull in non‐adults has recently received a lot of attention in the palaeopathological literature. These features appear as layers of new bone on the original cortical surface, expanding around meningeal vessels, as isolated plaques, ‘hair‐on‐end’ extensions of the diploë or, as ‘capillary’ impressions extending into the inner lamina of the cranium. These lesions are commonly found on the occipital bone, outlining the cruciate eminence, but have also been recorded on the parietal and frontal bones, and appear to follow the areas of venous drainage. Although recognized as resulting from haemorrhage or inflammation, their precise aetiology is still a matter of controversy. This paper outlines their possible causes and examines their nature and distribution in a group of non‐adults from four archaeological sites in England. It is recommended that, when recording these lesions in the future, additional skeletal pathologies, the age of the child, and nature and distribution of the lesions also be taken into account. Copyright © 2004 John Wiley & Sons, Ltd.     

Anthropological analysis of the phenomenon of atlas occipitalisation exemplified by a skull from twardogóra (17th c.)—southern Poland

Occipitalisation of the atlas is one of the most frequent osseous anomalies of the atlas. It is characterised by the adhesion of the first cervical vertebra with the basilar part of the occipital bone. The most probable cause of the occipitalisation is a congenital disorder. The atlanto‐occipital fusion may lead to narrowing of the space for medulla oblongata, spinal cord and vertebral artery. This in turn may lead to many physiological symptoms. The skull from Twardogóra, Southern Poland, showed partial atlanto‐occipital fusion and presented an asymmetry in structure and shape of apertures for the vessels and nerves around the foramen magnum. Copyright © 2011 John Wiley & Sons, Ltd.     

A temporal bone lesion in a modern subject to explain a defect in the Kabwe skull

The skull of a dissection room subject was noted to have a hole in the left squamous temporal bone similar to a lesion in the Kabwe (Broken Hill) skull. Kabwe man has an 8 × 8 mm hole situated 2 cm above and slightly anterior to the left external auditory meatus (EAM). This report describes a possible mechanism for the causation of that lesion, which is illustrated by features on a modern skull. The subject is a 55-year-old man who died from carcinoma of the stomach in 1942. The skull was macerated, defatted and stored after the cadaver had been dissected by medical students. In the squamous temporal bone there was an oval shaped 9 × 8 mm hole. The base of the oval was situated 11 mm above the superior margin of the EAM with the central axis of the hole being in line with the anterior margin of the EAM. This hole forms the base of a larger intracranial pit measuring 21 mm in diameter. The hole has an irregular margin except superiorly where it is smooth and rounded, indicative of healing. Intracranially, the petrous temporal bone displayed a marked exophytic, bony outgrowth suggestive of a chronic infective condition. The tegmen tympani contained a hole 3 mm in diameter in the middle of the exophytic area. No sign of disease in the mastoid process was noted. These findings are compatible with advanced chronic ear disease which has tracked into the extradural space through the tegmen tympani, become loculated, and then eroded the squamous temporal bone. The Kabwe skull shows signs compatible with chronic ear disease. It is suggested that a mechanism similar to the one described in the modern skull could explain the lesion in the left squamous temporal bone of Kabwe man.     

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.     

Craniofacial trauma in the Prehispanic Canary Islands

The current project is a study of craniofacial trauma in a large sample (n = 896) of Prehispanic Canary Islanders (PCIs). The possible causes and social implications of the trauma found are considered, with reference to archaeological and historical data. Variables include the island, period and ecology, the sex and age of the individuals, the distribution of lesions across the skull (by side and by individual bone) and ante‐mortem tooth loss. The results show a fairly high trauma rate (16%), a low prevalence of peri‐mortem trauma (3.8% of all lesions), higher prevalence of trauma in males than in females (25% vs. 13% of all individuals), more cranial than facial lesions (8.9% vs. 3.5% of all elements) and more lesions on the left side of the skull (6.7% vs. 4.5% of all elements) which suggests that the lesions were sustained through intentional rather than accidental agency. There was no correspondence between trauma prevalence and ecology. The archaeological and historical data support the assertion that the lesions may be the result of skirmishing between groups, using weapons such as slingshots, stones and staves. The presence of edged‐weapon lesions on some individuals suggests that these may have been the victims of contact‐period European groups. Copyright © 2007 John Wiley & Sons, Ltd.     

A case of beheading dating from the celtic period (la Tène B,Sarliève‐Grande Halle,France)

Excavation at the site of Sarliève‐Grande Halle, La Grande Halle revealed a large celtic necropolis dating from the 1st century BC. Burial number SP 2170 presented evidence of beheading. The position of the body showed a proper anatomical situation of the head in spite of a dislocation of C1–C2 and abnormal rotation of the head on the right side. Moreover, the arms were in an unusual position, with internal rotation of the humeri, the forearms crossed and the palm up position of left hand. The second cervical vertebra showed complete section of the odontoïd apophysis, associated with cutmarks on the vertebral body. The occipital bone had a large cut on the left side of the squama. These lesions correspond to those already described for decapitation in antiquity. The reconstruction of the chronology of the wounds as a form of execution is discussed in the historical context of the Celtic populations in Gaul. Copyright © 2004 John Wiley & Sons, Ltd.     

Bone changes in the human skull probably resulting from scurvy in infancy and childhood

Scurvy in children is poorly known in the palaeopathological literature despite biomedical references indicating that bone changes do occur in some cases and should be observable in human skeletal remains. Research on infants' and children's skulls in museum and anatomical collections in the USA and Europe reveals a complex of features on the external surface of the greater wing of the sphenoid and adjacent bone tissue that may be caused by scurvy. The lesions are bilateral and are characterized by porosity and, in some cases, hypertrophic bone formation. These abnormal bone changes are probably the result of a reaction to chronic haemorrhage in the deep vasculature associated with temporalis muscle function. While these lesions resemble those seen in anaemia and infection, their distinctive anatomical location and association with chewing should differentiate them, in most cases, from other disease conditions. These features are also associated with porous, hypertrophic lesions of the orbital roof and provide additional evidence that caution is needed in attributing porous lesions of the orbital roof solely to anaemia. © 1997 John Wiley & Sons, Ltd.     

Neurocranial Trauma in the Late Archaic Human Remains from Xujiayao,Northern China

The early Late Pleistocene late archaic human remains from Xujiayao, northern China, reveal several abnormalities of the neurocranial vault. The Xujiayao site is located on the northwestern boundary of the Nihewan Basin, and on the basis of various indicators, it dates to the early Late Pleistocene. Among the 15 human neurocranial elements found at Xujiayao in the 1970s, three elements show minor traumatic lesions of the external table: the largely complete Xujiayao 5a immature parietal bone, the Xujiayao 8 small piece of anterior right parietal bone and the Xujiayao 12 partial occipital bone. The lesions are all superior to the temporal or nuchal lines and hence were subcutaneous, covered only by the pericranium, the galea aponeurotica and the overlying skin. The external tables are variably concave with irregular bone within the bony depressions, and the diploë show varying degrees of involvement. The Xujiayao abnormalities join a series of minor neurocranial healed lesions among Pleistocene humans, as well as more pronounced healed neurocranial and facial trauma. Copyright © 2012 John Wiley & Sons, Ltd.     

Two medieval ‘trepanations’ – therapy or swindle?

During the 1991–1992 excavation of the ruins of the medieval cathedral in Hamar, Norway, the broken skull of an elderly man was found, showing evidence of an incomplete trepanation. The ‘surgeon’ had obviously tried to penetrate the skull surface around bregma in an irregular circle of 23 × 21 mm. Upon investigation, the skull revealed a reactive‐pathological area of the internal surface of the occipital bone, which probably represents a respite after a meningeal disorder (a tumour or an infectious process), causing us to suggest that the trepanation was meant to cure the patient's increasing headache. However, as a second skull with similar marks was found in the same churchyard, another explanation seems possible. Because the brain tumour in the first case may have altered the patient's mental state, we may surmise that these incomplete operations were an attempt to remove from these patients' heads the ‘Stone of Madness’, which was then commonly considered to be the reason for psychiatric diagnoses as well as persistent headache, and often depicted in European art, most notably in the 16^th and 17^th centuries. The second skull, revealing an even more incomplete attempt, did not show any skeletal pathology at all. Copyright © 2007 John Wiley & Sons, Ltd.     

A case study of possible differential diagnoses of a medieval skeleton from Denmark: leprosy,ergotism, treponematosis,sarcoidosis or smallpox?

This paper uses macroscopic and radiological examinations to provide differential diagnoses of pathological lesions in the skeleton of a young woman, 20–25 years of age, which triggered the Danish palaeopathologist Vilhelm Møller‐Christensen's interest in leprosy. The skeleton was incomplete, but the majority of bones of the upper body, as well as the skull, were present. The pathological changes consisted of medullary and cortical lytic foci, periosteal reaction and enhanced cortical density. The lesions were most extensive on the left side, especially around the elbow, wrist and scapula. Treponematosis, leprosy, smallpox, ergotism, rheumatoid arthritis, tuberculosis and sarcoidosis are all reviewed with regard to bone and joint pathology and their likelihood of being the correct diagnosis. We concluded that the most plausible diagnosis is treponematosis, but neither sarcoidosis nor smallpox can be completely excluded. Copyright © 2007 John Wiley & Sons, Ltd.     

A Case of Osteosarcoma in a Late Medieval–Early Modern Skull from Kyjov (Czech Republic)

After the reconstruction of the original parish church of the Moravian town of Kyjov in the latter part of the seventeenth century, human skeletal remains from the disturbed graves of the surrounding cemetery were gathered in a vault which was partially excavated in 1994. Among disarticulated bones of at least 106 individuals, a fragmented skull of a young male was found, with a massive outgrowth of bone on the right parietal, originally continuing fluently on the non-preserved frontal scale, on edges lifting the outer lamina. The inner lamina was covered less intensively by the bony growth. Radiography and CT scans showed a non-homogeneous structure, the inside being irregular and the outside granulated or radially striated. A metastatic lytic focus was detected in the same bone. Histology and SEM examination showed an uneven mineralization of the bone tissue, consisting of rough, thickened and irregularly spaced trabeculae, with cellular remains or mineralized matrix on the surface. The differential diagnosis took meningioma into consideration but the most probable diagnosis was osteogenic sarcoma, which is still infrequent in the palaeopathological record from the Old World and its localization in the cranial vault is very rare. © 1997 by John Wiley & Sons, Ltd.     

A multiple myeloma of the late middle ages from unterregenbach,southwestern Germany

In the early 1960s the grave of a probable donor was discovered in the St Veit church in Unterregenbach, Stadt Langenburg, Kreis Crailsheim, southwestern Germany. After a re-examination, the skeleton may be regarded as clearly corresponding to the typical clinical picture of a multiple myeloma/plasma cell myeloma. The 45–55-year-old female individual shows all the characteristics of a malignant plasma cell tumour, with specific osteolytic lesions of the skull, vertebrae, ribs, pelvis, scapulae and long bones, and even-sized single defects without reactive zones on the edges. Several pathological fractures of the ribs and a vertebral compression fracture can be observed. The gnawing-mark-like features on the inner surface of the compact bone and the ‘punched-out’ lesions on the outer are distinguishing marks of a multiple myeloma.     

Pre-Columbian congenital syphilis from the late antiquity in France

Today, exactly 500 years after the discovery of America, there is still a lot of controversy about the history of syphilis in Europe, especially about the Columbian and pre-Columbian hypotheses. This paper presents evidence for the presence of venereal treponematosis in the late Antiquity in France. The case that we examined comes from the necropolis of Costebelle (3rd-5th centuries AD; Hyères, Var, France). Grave no. 1 contained the well-preserved skeleton of a relatively old woman with the skeletal remains of an approximately 7-month-old fetus in her pelvic cavity. The osseous lesions of the fetal remains can be described in four groups: periosteal appositions on the skull vault (frontal and parietal); signs of periostitis on the long bones (bilateral cortical irregularities, predominantly on the left side, which affect first of all tibiae, femora, fibulae, radii and humeri, particularly in the metaphyseal region); some infraperiosteal detachment reminiscent of an infraperiosteal haematoma surrounding the distal extremity of the left forearm and the left hand; and finally, the irregular lesions of the humeral distal and proximal tibial metaphyses reminded us radiologically of Wimberger's signs. The most probable diagnosis of all the lesions mentioned above is that of a precocious congenital syphilis. This case consists of an argument against the epidemiological theories about the migration of Treponema pallidum from the New World back to the Old World starting at the end of the 15th century.     

The taphonomic attributes of a Late Cretaceous plesiosaur skeleton from New Zealand

The pre-burial history of a partial elasmosaurid plesiosaur skeleton is reconstructed from analysis of the distribution and modification of bones preserved in a calcareous concretionary mass. The specimen lacks the skull, cervical vertebrae, left limb bones and some girdle elements, but the remaining bones are interpreted to have been deposited on the sea floor from a semi-buoyant carcass and their relative positions modified by the action of scavengers. Bioerosive agents caused loss of bone, particularly on joint surfaces and vertebral centra, as the carcass lay exposed on the sea floor, perhaps for several years before burial.     

An Approach to the Diagnosis of Craniofacial Fibrous Dysplasia from the 2500‐Year‐Old Remains of a Skull from Ancient China

A human skull, buried about 2500 years ago in a Bronze Age cemetery at Jinggouzi, a site of an important ethnic group in ancient China, appeared to have characteristics of fibrous dysplasia. The CT images indicated a reduction in bone density and relatively homogeneous lesions. More features were revealed using CT reconstruction techniques. Lesions seen in low‐magnification images using a 3D deep‐field microscope had an irregular honeycomb‐like structure. At higher magnification, the trabeculae morphology and the gaps between the trabeculae were irregular and varied in size and shape. Paraffin‐embedded specimens stained with HE showed trabeculae with tortuous irregular arrangements varying in shape and width. The irregular trabeculae of woven bone has been described as having fibrous dysplasia. Molecular analysis of the GNAS gene indicated no mutation. This provides a non‐invasive approach for us to make more comprehensive diagnoses and to assist research into ancient human diseases.     

A Roman Skeleton with Possible Treponematosis in the North‐East of the Iberian Peninsula: A Morphological and Radiological Study

The main goal of this paper is to describe and discuss pathological lesions observed in a Roman skeleton (between 2^nd and 3^rd century AD) from the north‐east region of the Iberian Peninsula (St Nicasi 18–24 site. Gavà, Barcelona), which may be compatible with treponematosis. Most of the skeleton, with the exception of the neurocranium, was recovered. Only the left tibia was affected, whereas the rest of the recovered skeletal remains were unaffected. Macroscopic examination revealed a male individual between 25 and 30 years of age at death with a sabre‐shaped left tibia. The proximal half of the diaphysis was pitted and the bone overall enlarged. The surface of the tibia showed occasional vascular impressions where, in some instances, small raised plaques of new bone appeared to bridge over them, specifically in the most affected area of the proximal half of the tibia. No destructive lesions were observed. Radiographic examination and gross inspection at the cross section of the tibia showed encroachment into the medullary cavity of coarse cancellous bone and cancellization of the cortex. The observed lesions indicate that the tibia was affected by a chronic infectious disease. Differential diagnoses were considered, and these included other infectious diseases, fibrous dysplasia, Paget's disease, chronic varicose ulcers affecting bone and trauma, with the conclusion that the disease affecting the tibia could have been treponematosis. This could be significant in the history of the treponematoses being one of the oldest examples of treponematosis in pre‐Columbian Europe. Copyright © 2011 John Wiley & Sons, Ltd.     

Intracranial Arteriovenous Malformations as a Possible Cause of Endocranial Bone Lesions and Associated Neurological Disorder

Endocranial bone lesions have attracted intensive scientific debate on their aetiology. In recent literature, the lesions were almost exclusively interpreted as of infectious origin. In this paper, we give new insight into the aetiology of endocranial lesions, distinguishing the lesions of vascular origin from those caused by tuberculosis or other conditions. The analysis is based on a rare case of a young female individual who displayed multiple endocranial lesions with ‘serpens endocrania symmetrica’ morphology. The lesions were associated with an uncommon branching pattern of the middle meningeal artery and marked side differences in teeth pathology. Postcranial skeleton showed signs of the left upper limb weakness. The macroscopic finding of the endocranial lesions along with the skeletal evidence of neurological damage, together with characteristic radiological and histological features, can lead to diagnosis of arteriovenous malformations. This study aims to improve understanding of the aetiology of endocranial bone lesions. Copyright © 2012 John Wiley & Sons, Ltd.     

A possible case of ‘poll‐evil’ in an early Scythian horse skull from Arzhan 1, Tuva Republic,Central Asia

Occipital bone lesions on an Iron Age horse cranium from the burial mound of Arzhan 1, Tuva, Central Asia, are described and interpreted. Cavitations around the nuchal ligament attachment site on the skull are interpreted as foci of inflammation and necrosis following local infection. It is suggested that the pathology represents a case of ‘poll‐evil’, most likely due to a bacterial infection. The significance of such an interpretation is discussed, including its implications for disease ecology and the possible infection risks to contiguous animal and human communities of the first millennium BC in Central Asia. Copyright © 2009 John Wiley & Sons, Ltd.     

A possible case of coccidioidomycosis from the Los Muertos site,Tempe, Arizona

Coccidioidomycosis is a fungal disease endemic to southwestern North America and parts of Central and South America. Coccidioidomycosis frequently disseminates to the human skeleton and produces mostly lytic skeletal lesions. However, this disease is infrequently described within archaeological populations. As a result, it is important to report potential cases in order to improve current understanding of the appearance and distribution of lesions resulting from coccidioidomycosis in archaeological specimens. This study describes skeletal lesions in an adult male recovered from the Los Muertos site, Tempe, Arizona (AD 500–1450). These lesions are present on the inferior border of the left scapular spine, the medial portion of the left first metacarpal head, and the medial portion of the right first metatarsal. The lesions are predominantly lytic with sclerotic and, in some cases, healed cortical bone distributed around their margins. Evidence of skeletal healing is recorded within the destructive focus of one lesion. Geographical information on pathogen endemism, overall lesion distribution, and agricultural‐era Hohokom behaviour suggest that coccidioidomycosis is the most likely diagnostic option for these lesions. Mounting evidence for possible infections in the palaeopathological literature, combined with high frequencies of nutritional stress levels in endemic regions, suggests that coccidioidomycosis contributed at least moderately to morbidity in the American Southwest. Copyright © 2006 John Wiley & Sons, Ltd.