Retrospectacle: A Neuroscience Blog

How Trepanation Was Performed

Trepanation is a procedure where a hole is drilled into the skull, exposing the dura mater and brain for either medical (releif of pressure) or mystical (supposed heightened consciousness)purposes. It is likely the oldest procedure in neurosurgery and has been practiced by many ancient peoples all over the world.

A commenter on this post referred me to an amazing video he created animating the process of trepanation. Check it out, its really good (hat tip Jona!)

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I would say ‘don’t try this at home,’ but it looks like modern-day elective trepanation is already a fad in communities which embrace extreme body modification. I assume I don’t need to say it, but I will anyway: drilling into your skull at home is a really really bad idea. (Unless of course you are trying to rid your brain of the secret pattern of “pi” which is driving you insane. Then its ok.)

To learn more about trepanning, check out Mo’s excellent post on the topic.

Comments

  1. #1 Anon
    January 6, 2008

    My parents bought me a book, decades ago (I think I was in Jr. High School at the time), called “It all started with Hippocrates”; it was a hilarious (to me at the time, anyway) history of medicine. The book spoke of trepanning, and of skulls found by archaeologists with holes in them (footnote in book: “that is, the holes were in the skulls, not in the archaeologists”), some of which showed considerable healing after the operation. One skull, it was reported, had a fairly large number of holes in it, partially healed. The book reasons that either the early surgeries did not work, so that the later were required, or else “the man had been told he had a head for music, and wanted to turn it into a flute.”

    Another hypothesis was reported on as well–that the trepanning was not meant as a medical procedure (such as it is–”medical procedure” would have included “letting demons out of the skull), but as a step in preparing the skull for ceremonial use after its original owner was through with it, perhaps as a chalice (footnote: “thus the holes were not so much to let spirits out as to let them in”.)

  2. #2 Ghosty
    January 6, 2008

    Bizarre indeed. Let’s hope this fad dies out soon … before it’s practitioners do, at any rate.

  3. #3 McDawg
    January 6, 2008

    Yes I agree – I watched that video yesterday.

    I know a few Neurosurgeons and I can think of one in particular that will be interested in your recent postings.

    For patient confidentiality reasons I cannot be specific but I am in touch with many families where a family member has had a procedure performed where burring a small hole in the skull has been carried out. This is to allow intracerebroventricular (i.c.v.) injection of a compound which is unable to pass the blood brain barrier (BBB).

    Whilst this procedure/infusion was nothing new, this was and still is pioneering work in the field in question. The work is ongoing in real time.

    My understanding is that as with any medical procedure there is a degree of risk. This surgery carries a risk of 2.5%:- “The general and anaesthetic risks of complications in the implantation of a subcutaneous pump are about 2%. The ordinary risk of haemorrhage associated with ventricular cannulation is 0.5%.” Neurosurgeon “Mr T” who I quote directly from cannot be named for legal reasons (court injunction).

    Of the 30 or so patients in this particular field, I am only aware of one case where due a surgical error, the procedure caused a severe complication.

    My point in closing is that as Shelley says, CLEARLY “don’t try this (trepanation) at home” under any circumstances whatsoever. PERIOD.

    The ONLY reason we did this was because these patients all have different forms of the same set of invariably fatal neurodegenerative diseases and this was the ONLY substance known to man which showed any promise from in vivo lab work.

  4. #4 anon
    January 6, 2008

    This is not trepanation, rather this is the treatment for the injury where the skull is depressed by a blunt object trauma.

    It looks like trepanation because they use the initial drill to get a grip on the skull, but proceed to pull it out in a similar fashion to how a cork is removed from a wine bottle.

    Trepanation can be done in a similar fashion, however this exact medical treatment is most definitely not trepanation.

  5. #5 Caribou
    January 6, 2008

    I just looked up the definition on trepanation and it said:

    “a form of surgery in which a hole is drilled or scraped into the skull, thus exposing the dura mater in order to treat health problems related to intracranial diseases, though in the modern era it is used only to treat epidural and subdural hematomas, as an extreme body modification, and for surgical access for certain other neurosurgical procedures, such as intracranial pressure monitoring.”

    This procedure does drill a hole into the skull, and wouldn’t the “lifting” of the skulltop qualify as treatment?

  6. #6 Dave Briggs
    January 7, 2008

    I assume I don’t need to say it, but I will anyway: drilling into your skull at home is a really really bad idea.

    Thanks for the heads up! I am going to go put that drill away right now! LOL!
    Dave Briggs :~)

  7. #7 Abby Normal
    January 8, 2008

    Extreme body modification indeed! Computer case modding is a hobby of mine. But this would be so much cooler. Replace a portion of the skull with some molded acrylic, add some LEDs hooked up to a replaceable watch battery, and wholla, you can have a look unlike anyone else.

    Forget tattoos and piercings. You want the ultimate in self-expression? Then you want a Custom Cranium(tm)! Be the talk at parties. Impress women. Show the world you’re not afraid to share what’s on your mind, or a least what in your head.

    Now who wants one? I’ll give you a special rate.

    Legal notice: the writer is not responsible for any injury or fatality resulting from cranial modifications. “Custom Cranium” is a trademark of Abby Normal, all rights reserved

  8. #8 McDawg
    January 8, 2008

    Why don’t you “take a piece of my mind”.

    Yep, here’s the song:- http://www.macjams.com/song/34390

    The title is really Piece of my mind, but I sense our guest vocalist (Binky) actually refers to “Peace of my my mind”.

    Legal notice: the writer is not responsible for any injury or fatality resulting from listening/downloading this CC BY-SA track . “Piece of my mind” is in the public domain and share alike.

    Personally, I find 3mm drill bits far reaching for hard to get at bits of the frontal cortex – or was it a Gore-Tex? Something must have slipped my mind…..

    I must check ma pockets. Back in a jiffy.

  9. #9 Azkyroth
    January 11, 2008

    Why is my first thought “wow, what graphics software did they make that in?” x.x

  10. #10 filim
    November 17, 2008

    This is not trepanation, rather this is the treatment for the injury where the skull is depressed by a blunt object trauma.

    It looks like trepanation because they use the initial drill to get a grip on the skull, but proceed to pull it out in a similar fashion to how a cork is removed from a wine bottle.

    Trepanation can be done in a similar fashion, however this exact medical treatment is most definitely not trepanation.

  11. #11 filim
    November 29, 2008

    Another hypothesis was reported on as well–that the trepanning was not meant as a medical procedure (such as it is–”medical procedure” would have included “letting demons out of the skull), but as a step in preparing the skull for ceremonial use after its original owner was through with it, perhaps as a chalice (footnote: “thus the holes were not so much to let spirits out as to let them in”.)