Our Summary

This research paper is about a tool known as the lenticular that was used in ancient times to cut into the skull, a process known as trepanation. The lenticular was first introduced by a physician named Galen. There are drawings of the tool from the 16th century Renaissance period, but these illustrations show a tool that doesn’t seem well-suited to cutting bone. In an archaeological dig in Italy, researchers found a similar tool that looks like it would be better for this purpose.

The researchers in this study wanted to compare these two tools to see which one was better at cutting into the skull. They made copies of both tools and used them on a sheep’s skull. They also looked at how these tools were described in old medical texts.

The results showed that the Roman lenticular was able to cut into the skull more easily. The Renaissance tool, on the other hand, was not able to cut into the bone and only separated the skin-like covering of the brain from the bone. The researchers found that the lenticular was used to cut bone up until the 13th century. After that, the Renaissance tool was used more to smooth out rough bone surfaces and remove small bits of bone that were touching the brain covering.

The researchers concluded that people should be careful when looking at illustrations in old medical texts, as they might not accurately show how a tool was used.

FAQs

  1. What is the lenticular and what was its original purpose?
  2. How did the Roman lenticular and the Renaissance instrument perform in the study when used to cut cranial bone?
  3. What conclusion was drawn about the application of the two instruments in medical literature?

Doctor’s Tip

A helpful tip a doctor might tell a patient about craniotomy is to follow post-operative care instructions carefully to ensure proper healing and minimize the risk of complications. This may include avoiding strenuous activities, taking prescribed medications as directed, and attending follow-up appointments with your healthcare provider. It is important to communicate any concerns or changes in symptoms to your doctor promptly.

Suitable For

Patients who are typically recommended for craniotomy are those with conditions such as brain tumors, aneurysms, epilepsy, traumatic brain injuries, and other conditions that require surgical intervention within the skull. The decision to undergo a craniotomy is made based on the specific condition and the individual patient’s overall health and treatment goals.

Timeline

Before craniotomy:

  1. Patient undergoes various diagnostic tests such as MRI, CT scan, and angiography to determine the need for surgery.
  2. Patient meets with neurosurgeon to discuss the procedure, risks, and potential outcomes.
  3. Patient may undergo pre-operative evaluations such as blood tests and physical examinations.
  4. Patient is instructed on pre-operative fasting and medications to take before surgery.

After craniotomy:

  1. Patient is closely monitored in the intensive care unit for any complications such as bleeding or infection.
  2. Patient may experience post-operative pain and discomfort, which is managed with pain medications.
  3. Patient may need to stay in the hospital for several days to recover and be monitored for any post-operative complications.
  4. Patient undergoes post-operative follow-up appointments with the neurosurgeon to assess healing and discuss any further treatment or rehabilitation needed.
  5. Patient may undergo physical therapy or rehabilitation to regain strength and function after surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about craniotomy may include:

  1. What is the reason for recommending a craniotomy procedure?
  2. What are the potential risks and complications associated with a craniotomy?
  3. What is the expected recovery time and rehabilitation process after a craniotomy?
  4. Will I need any additional treatments or therapies following the craniotomy?
  5. How experienced are you in performing craniotomy procedures?
  6. Are there any alternative treatment options to consider before proceeding with a craniotomy?
  7. What type of anesthesia will be used during the procedure?
  8. Will I need to stay in the hospital after the craniotomy, and if so, for how long?
  9. What long-term effects or challenges should I be aware of after a craniotomy?
  10. Are there any specific instructions or precautions I should follow before and after the craniotomy procedure?

Reference

Authors: Ganz JC. Journal: J Neurosurg. 2024 Feb 2;141(1):27-31. doi: 10.3171/2023.11.JNS232042. Print 2024 Jul 1. PMID: 38306649