Reconstruction of skull defects in the middle ages and renaissance.
In Egyptian, Greco-Roman, and Arabic medicine, the closure of a skull defect was not provided at the end of a therapeutic trepanation or in cases of bone removal. The literature from the Middle Ages and Renaissance disclosed some striking and forgotten practices. Gilbertus Anglicus (c. 1180 to c. 1250) cites the use of a piece of a cup made from wooden bowl (ciphum or mazer) or a gold sheet to cover the gap and protect the brain in these patients; this citation probably reflected a widely known folk practice. Pietro d'Argellata introduced the use of a fixed piece of dried gourd for brain protection to reconstruct a skull defect. In the late Renaissance, the negative folklore describing this outlandish practice likely led to the use of silver and lead sheets. Nevertheless, for centuries, large numbers of surgeons preferred to leave the dura mater uncovered after bone removal, and failed to apply any brain protection.
Department of Neurology and Psychiatry, Neurosurgery, "Sapienza" University of Rome, Rome, Italy missorp@yahoo.com.
Paolo
P
Missori
Department of Medical-Surgical Sciences and Biotechnologies, Neurology Unit, Ospedale "A. Fiorini" Terracina, LT, "Sapienza" University of Rome, Polo Pontino, Rome, Italy.
Antonio
A
Currà
Department of Vegetable Crops & Plant Genetics, Agricultural Research Organization, Newe Ya'ar Research Center, Ramat Yishay, Israel.
Harry S
HS
Paris
Department of Neurology and Psychiatry, Neurosurgery, "Sapienza" University of Rome, Rome, Italy.
Simone
S
Peschillo
Department of Neurology and Psychiatry, Neurosurgery, "Sapienza" University of Rome, Rome, Italy.
Francesco
F
Fattapposta
Department of Medical-Surgical Sciences and Biotechnologies, Neurosurgery, IRCCS "Neuromed", Pozzilli, Italy.
Sergio
S
Paolini
Department of Neurology and Psychiatry, Neurosurgery, "Sapienza" University of Rome, Rome, Italy.
Maurizio
M
Domenicucci
D004388:Dura Mater; D049668:History, 15th Century; D049690:History, Ancient; D049691:History, Medieval; D006801:Humans; D019651:Plastic Surgery Procedures / Q000266:history* / Q000379:methods; D012886:Skull / Q000293:injuries* / Q000601:surgery*
bone; brain; cranioplasty; protection; skull; trepanation