Trepanation in archaic human remains - characteristic features and diagnostic difficulties.

Three trepanned skulls originated from a medieval archeological site at St. Pantelejmon Church, located in Serbia, all showing characteristic depressions and perforations of the vault of the skull from trepanning. Trepanation refers to the process of creating a defect in the skull by drilling, cutting or scraping and is one of the oldest known surgical procedures. Anthropological assessment of possible cases of trepanation in archaic material is complicated by a differential diagnosis that includes both congenital/developmental lesions such as parietal fenestrae, and acquired conditions such as trauma, infection and malignancy.