Paleo-pathology fans beware. Cranial surgery in the Neolithic period

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Marina Escolà. Alsatian Neolithic cranial surgery: state of the art. Bulletin de la Société préhistorique française, 2022, 119 (2), pp. 295-324. hal-03738889

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“The knowledge we have gained about the way of life of the first Neolithic populations in Alsace is due to a favorable conjuncture: the expansion of the Danubian Neolithic current, the strong human settlement in the loess plains, the good preservation of thousands of tombs and the recent exploitation of the land for building purposes. These optimal conditions led to the discovery and study of four Alsatian cases attributed to surgical procedures. The one from Hoenheim-Souffelweyersheim (Bas-Rhin), one of the earliest identified, comes from a recent ribboned context. This elderly subject has a large, centrally perforated right frontal depression, which may have been caused by the extraction of bone splinters following trauma. The opening in the cranial bone, initially the result of abrasion of the external table and diploe, was reopened and enlarged. The operation followed a phase of observation using a protocol that could be described as medical. The interest of two other cranial lesions lies in the complexity of the diagnosis made or to be debated, since the pathological is mixed up with, or has to be disentangled from… the mchirurgical. In the Danube cemetery of Ensisheim “les Octrois” (Haut-Rhin), burial 44 preserved the remains of a subject whose cranial vault showed two vast depressions, TR-1 (65 mm x 63 mm) and TR-2 (95 mm x 91 mm) in the median region, interpreted, on discovery, as healed craniectomies. The study of these two arch alterations reveals the complexity of the differential diagnosis. It highlights the diversity of possible pathologies and the lack of recent studies on the healing processes of such cranial defects. The Grossgartach Middle Neolithic necropolis at Lingolsheim (Lower Rhine) has yielded a burial site rich in accompanying furniture: tomb XLIV. The young adult who occupied it had a cranial lacuna described as a double trepanation. A study of the alteration and healing phases of the orifice margins has identified a sequence of three events that led to the perforation of the cranial bone, the pathological, taphonomic or anthropic origin of which deserves to be discussed. The diagnosis of trepanation for the subject from Riedisheim (Haut-Rhin), whose chronological attribution remains vague (Late Neolithic-Early Bronze Age), is supported by the presence of a few instrumental striations still visible on the cranial bone, despite notable healing of the orifice edges.”

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