title: Neurosurgery during the Bronze Age: a skull trepanation in 1900 BC Greece.
abstract: OBJECTIVE
  Paleoneurosurgery represents a comparatively new developing direction of neurosurgery dealing with archaeological skull and spine finds and studying their neurosurgical aspects. Trepanation of the cranial vault was a widespread surgical procedure in antiquity and the most convincing evidence of the ancient origin of neurosurgery. The present study considers a case of trepanation from the Middle Bronze Age Greece (1900-1600 B.C.).
  
  
  METHODS
  The skull under study belongs to skeletal material unearthed from Kirra, Delphi (Central Greece). Macroscopic examination and palpation, as well as three-dimensional computed tomography, were used in this study.
  
  
  RESULTS
  There is osteological evidence that the skull belongs to a man who died at 30-35 years of age. The procedure of trepanation was performed on the right parietal bone. Both macroscopic and computed tomography evaluation demonstrate an intravital bone reaction at the edges of the aperture. Projected on the right surface of the brain, the trepanation is located on the level of the central groove. The small dimensions and the symmetrical shape of this hole give us an indication that it was made by a metal tool.
  
  
  CONCLUSIONS
  We conclude that this paleopathological case provides valuable information about the condition of life and the pre-Hippocratic neurosurgical practice in Bronze Age Greece.
authors: Department of Paleopathology, University of Athens, Athens, Greece. Electronic address: demon@otenet.gr.
authors: Manolis J
authors: MJ
authors: Papagrigorakis
authors: Euromedica-ENCEFALOS, Athens, Greece.
authors: Panagiotis
authors: P
authors: Toulas
authors: Department of Paleopathology, University of Athens, Athens, Greece.
authors: Manolis G
authors: MG
authors: Tsilivakos
authors: Department of Paleopathology, University of Athens, Athens, Greece; Society of Junior Doctors, Athens, Greece.
authors: Antonis A
authors: AA
authors: Kousoulis
authors: Archaeological Ephoria in Delphi, Fokis, Greece.
authors: Despoina
authors: D
authors: Skorda
authors: Department of Neurosurgery, General Hospital of Athens, Athens, Greece.
authors: George
authors: G
authors: Orfanidis
authors: Department of Paleopathology, University of Athens, Athens, Greece.
authors: Philippos N
authors: PN
authors: Synodinos
mesh_terms: D000076145:Greece, Ancient; D049690:History, Ancient; D006801:Humans; D008297:Male; D009493:Neurosurgery / Q000266:history*; D010164:Paleopathology; D012886:Skull / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014207:Trephining / Q000266:history*
keywords: CT evaluation; Kirra; Trephination