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A case of hydrocephalus and its “neurosurgical” intervention on a woman from 18th century in France

Abstract : Archaeological excavation carried out in the cemetery of Saint-Jacques cemetery (Douai, Northern France) brought to light the skeletal remains of an 18 years old woman dated from 18th century. The individual S372 was discovered in a single burial, outside the church, in the cemetery around the chapel. The skeleton was well preserved, but the skull showed an impressive increased cranial capacity, reflected by an abnormal and enlarged morphology of the cranium vault. The skull had a very rounded, globular appearance with a distinct deformation of the occipital. We conducted MicroCT analysis (Ultratom, Rx Solution, Lyon, France) of the entire skull, in order to describe the cranial deformation. Moreover, using 3D virtual tools (AVIZO Fire 8, FEI), an endocast of the brain was performed, allowing us to analyze the lobes morphology and asymmetry, and the meningeal artery traces. Based on these observations, the individual S372 was diagnosed as having a hydrocephalus probably caused, either by an occlusion of cerebral aqueduct or an intracranial vascular malformation such as vein of Galen aneurysmal malformation (VGAM). Furthermore, the skull exhibited a 0.8 cm-long oval traumatic lesion along the lambdoidal suture resulting from a probable surgical intervention. The injury showed signs of healing suggesting that the individual survived this traumatic event for quite a long time. The lesion could be interpreted as the results of a trepanation. The typical oval shape and well-defined margins suggested the use of a hippocratic drill with toothed crown. The treatment of hydrocephalus is described by several medical authors, from antiquity to modern era. In the tenth century, Albucasis was the first to give details about the instruments used in decompression-trepanation as a treatment for hydrocephalus. Some reports from the sixteenth to the eighteenth century describe the hydrocephalus a disease that is difficult to diagnose and even more difficult to treat. This case represents a rare evidence of neurosurgical treatment used to treat a severe case of hydrocephalus during the modern period in France.
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Contributor : Cécile Chapelain de Seréville-Niel Connect in order to contact the contributor
Submitted on : Monday, June 3, 2019 - 6:46:14 PM
Last modification on : Monday, May 30, 2022 - 12:34:03 PM


  • HAL Id : hal-02146346, version 1



Daniela Lombardo, Valentina Giuffra, Joël Blondiaux, Gino Fornaciari, Thomas Colard. A case of hydrocephalus and its “neurosurgical” intervention on a woman from 18th century in France. Les nouvelles méthodologies en paléopathologie, colloque du Groupe des Paléopathologistes de Langue Française (GPLF), May 2018, Rouen, France. ⟨hal-02146346⟩



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