Cranial dysraphism mistaken for trephination.
Attention is called to a disputed diagnosis of trephination reported for a perforated skull of a prehistoric New England Indian. The perforation, surrounded by a saucer-like depression, is located exactly in the midline just in front of bregma. The finding of a similar lesion in a prehistoric Indian skull from the North Coast of Peru--where, as in New England, good evidence of the practice of trephination is lacking--provides support for a more reasonable diagnosis for both cases: congenital cranial dysraphism, specifically encephalocele. Information about dysraphic states from modern clinical experience is summarized.
D000885:Anthropology, Physical; D003937:Diagnosis, Differential; D004677:Encephalocele / Q000266:history* / Q000473:pathology; D005260:Female; D049690:History, Ancient; D006801:Humans; D007198:Indians, North American / Q000266:history*; D008297:Male; D008875:Middle Aged; D009511:New England; D009518:New York; D010164:Paleopathology; D010568:Peru; D012886:Skull / Q000473:pathology*; D014207:Trephining; D014481:United States