Cases of <i>serpens endocrania symmetrica</i> in young individuals from Neolithic Western Switzerland: Description and interpretation

Abegg, Claudine; Dutour, Olivier; Desideri, Jocelyne; Besse, Marie

doi:10.1002/oa.2863

Cited by 7 publications

(10 citation statements)

References 30 publications

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“…Paleopathological diagnosis of TB principally relies on the identification of macroscopic lesions in the human skeleton that have been found to be related to different manifestations of the disease (e.g., skeletal TB, pulmonary TB and/or TB pleurisy, and TB meningitis (TBM)) through clinical study [20][21]. Since the late 20 th century, a number of studies [e.g., 19,[22][23][24][25][26][27][28][29][30][31][32][33][34] were performed on osteoarchaeological series and documented skeletal collections that have revealed a positive association between TBM and a few endocranial alteration types, i.e., granular impressions (GIs), abnormally pronounced digital impressions (APDIs), abnormal blood vessel impressions (ABVIs), and periosteal appositions (PAs).…”

Section: Introductionmentioning

confidence: 99%

“…Although ABVIs and PAs on the endocranial surface have been considered as paleopathological diagnostic criteria for TBM based on the findings of previous studies that were performed predominantly on osteoarchaeological series [e.g., 19 , 23 , 25 – 26 , 29 , 33 ], they are not pathognomonic features of the disease. Therefore, the utilization of ABVIs and PAs in the paleopathological practice can be questioned, especially in consideration that most of the previous studies did not assess the diagnostic value of ABVIs and PAs on skeletons of known cause of death and/or did not include statistical data analysis.…”

Section: Introductionmentioning

confidence: 99%

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Tracking down the White Plague. Chapter two: The role of endocranial abnormal blood vessel impressions and periosteal appositions in the paleopathological diagnosis of tuberculous meningitis

et al. 2020

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Although endocranial abnormal blood vessel impressions (ABVIs) and periosteal appositions (PAs) have been considered as paleopathological diagnostic criteria for tuberculous meningitis (TBM) based on findings of previous studies, they are not pathognomonic for tuberculosis (TB). Therefore, their utilization in the paleopathological practice can be questioned, especially in consideration that most of the previous studies were not performed on identified skeletal collections but on osteoarchaeological material and did not include statistical data analysis. To fill the aforementioned research gap, for the first time, a macroscopic investigation was conducted on identified pre-antibiotic era skeletons from the Terry Collection. A sample set of 234 individuals who died of TB (TB group) and 193 individuals who died of non-tuberculous causes (NTB group) were examined. The frequency of ABVIs and PAs, as well as other probable TB-related lesions was recorded. To determine the significance of difference (if any) in the frequencies of ABVIs and PAs between the two groups, χ 2 testing of our data was performed. We found that ABVIs, PAs, and their co-occurrence with each other and with other probable TB-related lesions were more common in the TB group than in the NTB group. In addition, the χ 2 comparative frequencies of ABVIs and PAs revealed a statistically significant difference between individuals who died of TB and individuals who died of NTB causes. Our findings strengthen those of previous studies that ABVIs and PAs are not specific to TBM but can be of tuberculous origin. Therefore, they do have a diagnostic value in the identification of TB in human osteoarchaeological material, especially when they simultaneously occur with other probable TB-related lesions. Their prudent utilization provides paleopathologists with a stronger basis for diagnosing TB and consequently, a more sensitive means of assessing TB frequency in past human populations.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tracking down the White Plague. Chapter two: The role of endocranial abnormal blood vessel impressions and periosteal appositions in the paleopathological diagnosis of tuberculous meningitis

et al. 2020

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“…In terms of taphonomy, most bones received a score of "2" or "3", indicating that the bone surface should be sufficiently preserved to make pathological observations possible. This distribution was not even within the corpus, and some sites, such as Sion-Petit-Chasseur, were more affected by taphonomical processes than others (Abegg 2019).…”

Section: Completeness and Taphonomymentioning

confidence: 80%

“…Serpens endocrania symmetrica were found in several immature individuals ( Fig. 11), as well as patterns of periosteal reaction congruent with hypertrophic osteoarthropathy (Abegg et al 2020). As such, it appears that beyond the "simple" cases of periosteal reaction, it is likely that endemic infectious conditions, perhaps tuberculosis, were present within this population (Blondiaux et al 2015;Hershkovitz et al 2015;Anselmo et al 2016).…”

Section: Agementioning

confidence: 89%

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More than the sum of their parts: reconstituting the paleopathological profile of the individual and commingled Neolithic populations of Western Switzerland

Abegg¹,

Desideri²,

Dutour

et al. 2021

Archaeol Anthropol Sci

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This research focuses on the Neolithic populations of Western Switzerland (5500–2200 BCE) and on establishing their paleopathological profile. This chronological period presents varying burial practices, and the aim was to be able to synthesise all information regarding the pathologies these populations exhibited, in such a way that statistical tests could be performed to determine whether geographical (site location), biological (age, sex, stature) and chronological factors played a role in lesion distribution. As a result, a methodology was devised to consider bone lesions in both a quantified and qualified manner, and able to handle individualised, multiple and commingled remains. The statistical analysis showed that pathological profiles differed depending on site location, with some exhibiting patterns that raise further questions as to the socio-economical functioning of these prehistoric societies. Biological factors also appear to play a role in lesion distribution, with immature individuals exhibiting more metabolic deregulations, whilst the adults—as expected—showed more signs of degenerative pathologies. Some chronological evolution of health is also perceivable; however, the small sample size available for some periods means these results are tentative at best. These remains, however, proved more than an accumulation of bone lesions, and the qualified data collected from them also yielded individual and collective narratives of health. Instances of infectious diseases were discovered, indicating that pathologies such as tuberculosis were a persistent presence at the time, with all the consequences this entails.

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Insights into the diagnostic efficacy and macroscopic appearance of endocranial bony changes indicative of tuberculous meningitis: Three example cases from the Robert J. Terry Anatomical Skeletal Collection

Spekker

Hunt

Berthon

et al. 2022

Intl J of Osteoarchaeology

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Recently, the combined macroscopic and statistical evaluation of 427 identified pre‐antibiotic era skeletons from the Terry Collection (Washington, DC, USA) revealed that there is a positive association between tuberculous meningitis (TBM) and four endocranial alteration types, namely, granular impressions (GIs), abnormal blood vessel impressions (ABVIs), periosteal appositions (PAs), and abnormally pronounced digital impressions (APDIs). Although all the four lesion types can be used as diagnostic criteria for TBM in the paleopathological practice, they do not have the same diagnostic value. The first aim of the current paper is to further highlight the diagnostic value of GIs, ABVIs, PAs, and APDIs by calculating and discussing their diagnostic sensitivity and specificity estimate values, as well as their association with each other from the 427 identified pre‐antibiotic era skeletons of the Terry Collection. The second aim is to demonstrate three example cases from the Terry Collection, who exhibit bony changes on the inner skull surface that are representative of the macromorphological appearance and co‐occurrence of GIs, ABVIs, PAs, and APDIs (in different combinations). Based on the generated sensitivity and specificity estimate values, GIs are sufficient enough on their own to make a definitive diagnosis of TBM, whereas ABVIs, PAs, and APDIs are not specific to the disease but can be of tuberculous origin. The χ2 test results regarding the association of ABVIs, PAs, and APDIs revealed that their co‐occurrence with each other (in any possible combination) is significantly more common in individuals who died of TB than in those who died of non‐TB causes—it implies that the chance of them being tuberculous in origin is higher when they simultaneously occur with each other. The three cases demonstrated in detail in the paper provide paleopathologists with a stronger basis for identifying TBM in ancient human remains that reveal endocranial alterations resembling that of the presented cases.

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Cases of serpens endocrania symmetrica in young individuals from Neolithic Western Switzerland: Description and interpretation

Cited by 7 publications

References 30 publications

Tracking down the White Plague. Chapter two: The role of endocranial abnormal blood vessel impressions and periosteal appositions in the paleopathological diagnosis of tuberculous meningitis

Tracking down the White Plague. Chapter two: The role of endocranial abnormal blood vessel impressions and periosteal appositions in the paleopathological diagnosis of tuberculous meningitis

More than the sum of their parts: reconstituting the paleopathological profile of the individual and commingled Neolithic populations of Western Switzerland

Insights into the diagnostic efficacy and macroscopic appearance of endocranial bony changes indicative of tuberculous meningitis: Three example cases from the Robert J. Terry Anatomical Skeletal Collection

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