Eli5: Why isn’t mortality after trepanation higher?

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I’ve read a study in which is explained how trepanation in Kenya is common. It is done with water as disinfectant, a blade which might be sharpened during the procedure with a rock, no anesthetic, no sutures. They use leaves which have coagulation properties and an ointment with butter. In most western countries craniotomy is complex and considered a serious surgery even with the right equipment.

I’ve read that the survival rate is about 93-94%. There was a guy who had 30 of trepanations done.

Where is the blood loss? Hypovolemic shock? Trauma shock? Infection? How do they not cause permanent brain damage?

In: Biology

2 Answers

Anonymous 0 Comments

in my opinion: natural herbs can be really good disinfectants. those people has strong immune system as they are already the survivor ones. (many infants die after birth ). and those who had it can stay traumatised.

Anonymous 0 Comments

> Where is the blood loss?

The skin over the skull is pretty thin and doesn’t usually have massive arteries or veins. Head wounds do tend to bleed relatively profusely but they are usually very easy to control, there being a convenient hard bone surface against which to apply pressure to stop bleeding.

Similarly the bone of the skull doesn’t have a significant blood supply flowing through it, so scraping off a section isn’t likely to result in massive blood loss.

> Infection?

That is a big one, and comes down to the strength of the human immune system. A 6-7% death rate is *huge* for modern surgeries, so it is still wildly dangerous from the perspective of modern Western medicine. Avoiding permanent brain damage is achieved simply by avoiding the brain; the goal is to remove the skull bone, not to impact the brain at all. If they do continue on and pierce the brain I expect death is virtually certain.