Cranial surgery in the North Pontic region during the 3rd millennium BC.

This study examines the development of cranial surgery in the North Pontic region during the Early and Middle Bronze Age (late 4th and 3rd millennium BC according to the Eastern European chronology). 389 skulls from burials of this period were examined for evidence of surgical intervention. Twenty five such cases were identified and analysed for sex, age, temporal and spatial distribution, size and number of lesions, signs of healing, technique, motivation and complications of the surgery. The study indicates that cranial surgery was a well-developed medical practice in the North Pontic region during the period under consideration. Most of the cases are concentrated in the Dnipro steppe area, suggesting the possibility of outlining another centre of cranial surgery on the map of Europe. The predominant trepanation technique used here was scraping, although alternative methods were also practised. Treatment of traumatic injuries is considered to be one of the main reasons for cranial surgery in our sample. The percentage of individuals who underwent cranial intrusions increased significantly from 1.2% in the first half to 10.4% in the second half of the 3rd millennium BC, indicating a chronological shift in the distribution of cranial surgery. This trend is believed to be related to changes in weaponry during the Middle Bronze Age. The introduction of stone battle axes and maces as common weapons led to a significant increase in the occurrence of blunt force injuries, both depressed and penetrating. Trepanation may have been employed as an effective medical treatment for such traumas.