Cranioplasty in ancient Peru: a critical review of the evidence, and a unique case from the Cuzco area

Abstract

Cranioplasty is a well-known procedure in modern neurosurgery. Although some authors have claimed it was also performed by prehistoric trepanners in various parts of the world, there is little hard evidence to support this. Here we review various claims of cranioplasty in Peru, where trepanation was widely practised in Prehispanic times. We find little support for assertions that cranioplasty was common. One recently discovered burial from the Cuzco region, however, provides the first documented case of the reinsertion of a bone plug into a trepanation opening.

Survival after trepanation—Early cranial surgery from Late Iron Age Switzerland

“…About two thousand trephined skulls dating from 500 BC to 1500 AD have been reported from Peru (Andrushko and Verano, 2008;Jørgensen, 1988;Kurin, 2013;Marino and Gonzales-Portillo, 2000;Rose, 2003;Verano, 2003;Verano and Andrushko, 2010). Trepanations are also recorded from other South American countries, such as Bolivia (Juengst and Chávez, 2015), Colombia (Gomez, 1973) and Mexico (Christensen and Winter, 1997;Velascosuarez et al, 1992;Wilkinson, 1975).…”

“…Trepanation in Europe is known to have been practiced since the Neolithic (Roberts and Manchester, 1995;Verano and Andrushko, 2010;Weber and Wahl, 2006) including several recent reports, e.g. from Italy (Novak and Knüsel, 1997), Germany (Piek et al, 1999;Weber and Wahl, 2006), Poland (Lorkiewicz et al, 2005) and Portugal (Gama and Cunha, 2003;Silva, 2003).…”

Three trepanned skulls from the Copacabana Peninsula in the Titicaca Basin, Bolivia (800 BC–AD 1000)

“…These surgeries were likely performed with tools made from obsidian or metal. Covers or plaques made of metal or bone and herbal poultices (as found with mummified remains in the Peruvian highlands) may have been used in post-operative treatment (Andrushko and Verano, 2008;Kurin, 2013;Verano and Andrushko, 2010). However, most examples are found without such artifacts.…”

Tibial surgery in ancient Peru

“…Several archaeological examples of surgery 1 have been described by Verano et al (2000) and Verano and Andrushko (2010) with specific examples of bone healing after substantial injury, amputation, or surgical intervention. The individuals from the coastal site of Huacas de Moche with lower leg amputations showing evidence of healing clearly reflect drastic procedures, although whether they were therapeutic or punitive interventions remains unclear (Verano et al, 2000).…”