The Pearls and Pitfalls of Skull Trephination as Described in the Hippocratic Treatise “On Head Wounds”

Abstract

The purpose of our current study is to describe the guidelines regarding trephination as suggested in the Hippocratic writer's book, “Peri ton en cephali traumaton” (“On Head Wounds”). The ancient Greek text was reviewed as well as two English translations. The Hippocratic author described the indications, timing, and techniques of trephination for patients with head injury. He emphasized that attention should be paid to the details of the employed technique. He also commented on the difference of skull thickness at different anatomical sites and also between different age groups. The Hippocratic recommendations provided details for the performance of trephination by the ancient Greek physicians that are still considered important in modern neurosurgery.