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Skull Shows 3,750-Year-Old Brain Surgery

An ancient skull found on a London riverbank with a large hole in it shows that brain surgery was performed at least 3,750 years earlier than thought.

The skull, dated by English Heritage to 1750 B.C., belonged to an adult male. The hole in the top of the skull was made during a gruesome operation called trepanation. In that procedure, a piece of bone was removed — probably by scraping with a tool — possibly to alleviate pressure on the brain, according to an English Heritage press release Wednesday.

Migraines, hallucinations, or epilepsy are other possible illnesses that might have warranted such a drastic procedure, English Heritage speculated.

The patient was most likely awake during the immensely painful operation, but this man lived on for a few more years after the roughly 1 by 2-inch hole (30 by 45 millimeters) was plugged, mostly likely with tree bark or leaves. Accounts from the 1920s of trepanning in the South Pacific describe the surgeon peeling back flaps of skin, then covering the hole with a coconut shell and banana leaves.

About 40 examples of trepanning have been found in Britain, dating from Neolithic to post-medieval periods, said the press release.

Simon Mays, an English Heritage expert on human skeletal remains, said: "Trepanning is probably the oldest form of surgery we know. The trepanning on this skull would have been carried out with a scraping tool, probably a flint, using great care to avoid piercing the brain. There is no evidence of any post-operative infection, which would have been the main cause of death in these operations, and the trepanation probably didn´t cause this patient any lasting problems. The skull shows that there were people in Britain at the time with significant anatomical and surgical skills, ones not bettered in Europe until Classical Greek and Roman times more than a thousand years later."

At the time the man, dubbed Chelsea Man, lived in London, the city consisted of small settlements strung along the river Thames.

Why the skull ended up in the Thames is a mystery, said English Heritage.

Jane Sidell, English Heritage Adviser in Archaeological Science, said: "It may have been the subject of a ritual burial as the river seems to have become a focus of spiritual and ceremonial attention during the Bronze Age. Several hundred skulls dating from prehistoric times, many of men aged between 25 and 35 without any accompanying skeletons, have been recovered from the Thames, as well as high status metalwork such as swords, shields, rapiers, daggers and spearheads. The weapons were presumably thrown into the waters in a display of wealth and power."

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