Trepanning

Trepanation, also spelled trepanning, is the surgical creation of an opening in the skull. The procedure involves removing a section of bone or drilling a hole to access the brain or relieve pressure. In the archaeological record, trepanation is the oldest known surgical practice, with evidence dating from the Neolithic period and found in many regions, including Europe, the Americas, and Africa. Some skulls from prehistoric contexts show signs of healing, indicating survival after the operation.

Historically, trepanation has been performed for a variety of reasons. Medical explanations include relief of intracranial pressure after head injury, removal of bone fragments, and treatment of symptoms such as severe headaches or seizures. In addition, certain cultures attributed ritual or spiritual significance to the procedure, viewing it as a means to influence the mind or release perceived spiritual forces. Techniques varied by culture and era, ranging from simple scraping and sawing to more complex drilling with metal or stone tools.

In modern medicine, the concept survives in a controlled form. Contemporary equivalents are burr holes and craniotomies performed to treat traumatic injury, subdural hematomas, tumors, or other brain conditions. These procedures are carried out with sterile technique and advanced imaging, and they carry risks such as infection, bleeding, and neurological injury. The historical term trepanation is now primarily used in medical history, anthropology, and archaeology to describe these ancient practices, rather than as a common clinical procedure.

See also: burr hole, craniotomy, craniectomy.