2Archaeologists searching in regions with a history of advanced civilizations have found evidence of the knowledge of brain surgery, using techniques thought to be unknown to practitioners of medicine before the 19th century.
3The Edwin Smith Papyrus Dated and authenticated at 16th Century BC.It is believed to be a copy from a text 1,000years older.Details surgical procedures, 48 of which aretraumatic injuries, and many of those are forbrain injuries, with descriptions of the physicalexam, treatment, and prognosis.Cranial sutures, meninges, external surfaceof the brain, cerebrospinal fluid, and intracranialpulsations are described in detail.
5The earliest evidence of brain surgery is thought to be from the middle stone age (10-12,000 years ago, found in a site on the Dnieper River in Russia. There is another site in Spain where a skull with trepanation dates to 10,000 BP.The skull above is from Peru and dates to approximately 400 BC.
8Trepanation (from the Greek trypanon for drill, or auger) is a procedure by which pressure is relieved from the surface of the brain.Trepanation from the Kashmir region of India/Pakistan, dated approximately 2000 B.C.
9Tools, such as these replicas, were first made of stone, but were stillcapable of making perfect holes as seen in this specimenfrom the late neolithic period.
10Trephinations were mainly used to relieve pressure on the skull, caused by swelling of the brain, much the same way a person relieves the pressure of a subungal hematoma.
11Head injuries in ancient times were mainly due to blunt force trauma from a club or stone. Today theyare most frequently caused by automobile accidents,