New cases of trepanations from the 5th to 3rd millennia BC in Southern Russia in the context of previous research: Possible evidence for a ritually motivated tradition of cranial surgery?
OBJECTIVE
It is a big challenge to diagnose the motives behind trepanations in prehistoric crania. Surgical-therapeutic attempts may be apparent by the presence of fractures, however, ritual or nonmedical motives are rarely supported by visible evidence in the bones. This article presents data on the trepanations of several individuals from South Russia dating to the Eneolitic and Bronze Age that may indicate a ritual procedure. In these crania an operation was performed in the identical location, the midline, furthermore in one of the most dangerous places, on the obelion. No evidence for traumatic or other pathological reasons for performing the operations was observable.


METHODS
Investigations of two nearby areas of South Russia revealed 13 individuals showing complete perforations in the midline of the cranium. Another one, displaying a depression in the same place, primarily diagnosed as an incomplete trepanation, is discussed considering all differential diagnoses. The trepanations were investigated macroscopically, by plain radiography and computed tomography. The lesions were described in detail, including data on technique, position, size, shape, state of healing, and complications.


RESULTS
Males and females received the operation between the age of 10 years and mature/senile age. Only grooving and scraping techniques were used and their application differed between sexes. The majority of the patients survived the intervention for a long time.


CONCLUSIONS
The region of Southern Russia seems to be a center for special trepanations performed by skilled surgeons, the specific position of the perforations implying more a ritual than therapeutic reason for trepanning. Am J Phys Anthropol 160:665-682, 2016. © 2016 Wiley Periodicals, Inc.
Department of Natural Sciences, German Archaeological Institute, Berlin, 14195, Germany.
Julia
J
Gresky
Institute of Arid Zones of the Southern Scientific Centre, RAS, Rostov-on-Don, 344006, Russia.
Elena
E
Batieva
Center of Egyptological Studies, Russian Academy of Sciences, Moscow, 123001, Russia.
Alexandra
A
Kitova
SUE "Nasledie" Ministry of Culture of the Stavropol Region, Stavropol, 355006, Russia.
Alexey
A
Kalmykov
OOO "Nasledie", Stavropol, 355006, Russia.
Andrey
A
Belinskiy
Eurasia Department, German Archaeological Institute, Berlin, 14195, Germany.
Sabine
S
Reinhold
Research Institute and Museum of Anthropology, Moscow State University, Moscow, 123001, Russia.
Nataliya
N
Berezina
D000293:Adolescent; D000328:Adult; D000885:Anthropology, Physical; D005260:Female; D049690:History, Ancient; D006801:Humans; D008297:Male; D008875:Middle Aged; D010164:Paleopathology; D012426:Russia; D012886:Skull / Q000473:pathology* / Q000601:surgery*; D014207:Trephining / Q000266:history* / Q000379:methods*; D055815:Young Adult
Bronze age; Eneolithic; caucasus; pseudo-trepanation; ritual