TREPANATION IN ITALY: A REVIEW OF THE LITERATURE AND A NEW CASE

We present a review of skull trepanation in ancient Italy, on the basis of the literature. A total of 54 cases are documented from 43 Italian archaeological sites, with particular abundancy from central Italy and prehistoric Sardinia. Evidences cover a time span of approximately 7000 years, with the most ancient cases dating back to the 5th millennium BC and the most recent to the 18-19th centuries AD. The analysis of the archaeological context reveals that in general there are no differences between individuals submitted to the practice of trepanation and other skeletons found in the same necropolis. The majority of individuals show a single trepanation, whereas others present skulls with multiple holes. The surgical intervention was reserved to adult individuals, with a prevalence of males. Considering the localization of trepanation, the parietals are the most preferred skull bones for trepanation, followed in decreasing incidence by the frontal and the occipital bone. The most diffused technique is scraping, whereas cutting and drilling are less attested. In some cases trepanation was performed to treat head wounds, but in several specimens it was not possible to determine the reasons for intervention. The percentage of survival in the Italian sample is very high, reaching 89% of the trepanned patients. The new case is represented by a trepanation practiced on an adult male coming from 13th century Tuscany in order to treat a bone injury; the intervention was carried out through the incision technique with the replacement of the bone rondella, but was unsuccessful and the patient died soon after