[Neurological paleopathology in the pre-Columbine cultures of the coast and the Andean plateau (II). The history of cranial trepanations].
OBJECTIVE
Trepanation is one of the earliest examples of a surgical procedure being carried out by human beings and was performed from the Neolithic period onwards in a large number of primitive cultures throughout the five continents. Trepanation and cranial deformation were both common in the pre-Columbine cultures. The aim of this work was to study the trepanations carried out by the ancient Paraca, Nazca, Huari, Tiahuanaco and Inca cultures. To do so, we conducted a field study involving visits to archaeological remains and anthropological museums on the Andean plateau and the Peruvian coast.


METHODS
In the pre-Columbine cultures, trepanation was performed on both men and women for therapeutic purposes (depressed fractures, epilepsy, vascular headaches and those associated to artificial cranial deformations) and as a ritual. Signs of trepanation have been found in 5% of skulls and 80% of these show evidence of the 'patient' having survived such an intervention. Some of them have several holes in different stages of healing. The trephining procedure involved the use of obsidian knives with wooden handles and tumis, which were ceremonial knives that were used to cut the scalp. Gold and silver cranioplasty plates have also been found in some skulls.


CONCLUSIONS
Cranial trepanation was very successful despite the rudimentary methods and instruments employed to perform it.
Carod-Artal
F J
FJ
Servicio de Neurología, Hospital Sarah, Brasilia DF, Brazil. javier@bsb.sarah.br
Vázquez-Cabrera
C B
CB
D003469:Culture; D005260:Female; D049690:History, Ancient; D006801:Humans; D007199:Indians, South American; D008297:Male; D008519:Medicine, Traditional; D010164:Paleopathology; D012886:Skull / Q000473:pathology* / Q000601:surgery*; D013020:South America; D016896:Treatment Outcome; D014207:Trephining / Q000266:history* / Q000295:instrumentation / Q000379:methods