Early evidence of brain surgery unearthed in Ancient Near East

It's well-known that people have practiced surgeries for the earliest days of history. Besides the old surgical techniques, the surgical tools also shed light on modern medicine today.

Led by Brown University, the new study shows that one specific type of brain surgery dates back to at least the late Bronze Age, according to recent excavations at the ancient city of Megiddo in Israel.

Rachel Kalisher, a Ph.D. candidate at Brown University's Joukowsky Institute for Archaeology and the Ancient World, led an analysis of the excavated remains of two upper-class brothers who lived in Megiddo around the 15th century B.C.

She discovered that one of the brothers had undergone angular notched trephination, a particular kind of cranial surgery. The process entails cutting the scalp, carving four intersecting lines in the skull using an instrument with a sharp beveled edge, and creating a square-shaped hole with leverage, as stated by Brown University.

The process entails cutting the scalp, carving four intersecting lines in the skull using an instrument with a sharp beveled edge, and creating a square-shaped hole with leverage.

"We have evidence that trephination has been this universal, widespread type of surgery for thousands of years," Kalisher said. "But in the Near East, we don't see it so often — there are only about a dozen examples of trephination in this entire region. My hope is that adding more examples to the scholarly record will deepen our field's understanding of medical care and cultural dynamics in ancient cities in this area."

They were probably from a royal family

According to co-author of the study and director of the University of Haifa's Institute of Archaeology and Maritime Cultures, Israel Finkelstein, 4,000 years ago, Megiddo was the hub of trade and served as a gateway to other Mesopotamian cultures, including those of Anatolia, Egypt, Syria, and others.

According to Kalisher, the two brothers whose bones she examined came from a residential area next to the late Bronze Age palace at Megiddo, indicating they were likely affluent citizens and perhaps even royalty.

Kalisher identified various bone anomalies in both boys throughout her study. The older sibling may have had a congenital abnormality like Cleidocranial dysplasia since he had an extracranial suture and an extra tooth in one corner of his mouth. The brothers' development may have been influenced by the mild signs of prolonged iron deficiency anemia in their bones.

These developmental anomalies could explain the brothers' early deaths—one in his teens or early 20s and the other anytime between his 20s and 40s.

The study was published in PLOS ONE.