Healed impact trauma to a Neolithic cattle frontal bone: A posthuman perspective.

Trauma associated with slaughter is identified occasionally archaeologically in the cranial remains of domesticated animals, with evidence for pole-axing occurring in Europe, especially from the Roman period onwards. The injury typically extends through the frontal bone and sinuses to penetrate the braincase, causing haemorrhage, loss of consciousness, brain damage, and death. Evidence for slaughter methods in the British Neolithic, however, is lacking. We report such evidence from a healed blunt-force impact trauma to the frontal bone of a domestic cattle skull from Beckhampton Road Neolithic long barrow, Wiltshire. The injury suggests a failed attempt at slaughter. To our knowledge, this is the first such report for domestic cattle from the British Neolithic. We contextualise this discovery, drawing on research into the role and meaning of faunal remains from Neolithic long barrows in Wiltshire. This work has been undertaken from a posthuman perspective. Thus, we demonstrate the opportunities for paleopathologists to inform and engage within posthumanist interpretative frameworks.

Violence in the Early Bronze Age. Diagnosis of skull lesions using anthropological, taphonomic and scanning electron microscopy techniques.

In this paper we present the study of a skull belonging to a young male from the Italian Bronze Age showing three perimortem injuries on the frontal and parietal bones; the peculiarity of the frontal injury is represented by its singular shape, which may be indicative of the weapon that caused the lesion. The aim of the present study is to examine the traumatic evidence in relation to possible etiological factors, in order to attempt to establish if the lesion occurred peri or post-mortem, and to evaluate if these traumatic injuries could be interpreted as an evidence of interpersonal violence, by combining anthropological, taphonomic and ESEM investigations. The combination of multidisciplinary methods of study can provide important new insights into inter-personal violence.

Pott's puffy tumor in children.

INTRODUCTION: Pott's puffy tumor is characterized by subperiosteal abscess associated with osteomyelitis of frontal bone. Reports are limited for this rare entity in the antibiotics era but increase during past decade. METHODS: We had clinical analysis of a series with six consecutive pediatric patients of Pott's puffy tumor during 20 years in a tertiary medical center via retrospective chart review. One case was described in detail. RESULTS: Male-to-female ratio was 5:1. The mean age at the time of diagnosis was 13 years-3 months. The risk factors were acute sinusitis in two (33%), chronic sinusitis in two (33%), recent head trauma in two (33%), and acupuncture therapy on skull in one (17%). The commonest presenting symptoms were fever, headache, forehead tenderness, vomiting, and fatigue/malaise (100%). Pott's puffy tumor was diagnosed on average the seventh day after fever, and half had intracranial involvement at diagnosis. All had intracranial infections, and most of them had subdural empyema. The most often involved sinus was frontal sinus (100%). The frontal lobe was the most common site of intracranial infection (100%), two thirds of which are polymicrobial from two or more sites. The initial operation was performed on average on the 5.8th days after diagnosis. Half of the patients underwent reoperation. The mortality rate was 17% (one of six). CONCLUSION: The symptoms of Pott's puffy tumor are inconspicuous even though early intracranial involvement often occurred. The importance of early diagnosis and aggravated and prompt treatment with prolonged antibiotic therapy is emphasized for better outcome.

Long-term histologic analysis of bone tissue alteration and healing following Er:YAG laser irradiation compared to electrosurgery.

BACKGROUND: The erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser is reportedly useful for periodontal therapy. However, the potential thermal damage that Er:YAG laser irradiation can produce on bone tissue has not been fully clarified. The purpose of this study was to histologically examine the effects of the Er:YAG laser on bone tissue and subsequent wound healing compared to electrosurgery in a long-term study. METHODS: Calvarial bone from 30 rats was exposed to contact and non-contact Er:YAG laser irradiation (115 mJ/pulse, 10 Hz) without water coolant, or electrode contact. The treated surfaces were analyzed by scanning electron microscopy (SEM), and the healing process was histologically observed until 12 months post-surgery. RESULTS: Contact irradiation resulted in substantial bone ablation, whereas non-contact irradiation produced slight tissue removal. Histologic and SEM analyses of the lased surface showed no severe thermal damage, except for the production of a superficially affected layer with a microstructured surface. The layer did not inhibit new bone formation, and the ablated defect was repaired uneventfully. Although the thickness of the layer gradually decreased, it generally remained in the cortical bone through the observation period. Electrosurgery produced a large area of thermal necrosis without ablation, and the damaged area was not replaced with new bone. CONCLUSIONS: Unlike electrosurgery, Er:YAG laser irradiation without water coolant easily ablated bone tissue, and thermal alteration in the treated surface was minimal. The superficially affected layer did not interfere with the ensuing bone healing, resulting in favorable repair of the defect.

Pott's puffy tumor after acupuncture therapy.

We report a case of Pott's puffy tumor (PPT) with Pseudomonas infection occurring after acupuncture therapy in a ventilator-dependent child. Acupuncture use has been growing during the past decade in the whole world. Infectious complications range from benign to lethal. PPT is a subperiosteal abscess of the frontal bone associated with underlying osteomyelitis. It presents as a localised swelling of the forehead. This paper describes a 12-year-old girl with PPT. To our knowledge, this is the first case report of PTT caused by acupuncture therapy.

Ivory osteoma of the craniofacial skeleton.

The authors describe the clinical presentation, investigation, and surgical management of two cases of benign ivory osteoma of the craniofacial skeleton. In the first case, a bony mass located over the frontal region had become a cosmetic burden to the patient, and she requested removal with minimal morbidity. Accordingly, an endoscopic procedure, with minimal access incisions located behind the hairline, was devised. In the second case, the patient, a Jehovah's Witness, presented with a long history of slowly enlarging bony masses over the maxilla and in the pterygopalatine space. She finally requested surgical intervention when the symptoms of pain related to fifth nerve compression at the foramen ovale became intolerable. Key aspects of the preoperative and perioperative management strategies used to avoid blood transfusion are detailed, as is the surgical approach, which included a bicoronal scalp flap with temporary removal of the zygomatic arch and the coronoid process. Finally, the etiology, histology, and natural history of ivory osteomas are discussed.

Cranial reconstruction for metastatic breast cancer.

All women with advanced breast cancer who are medically stable despite their disease are candidates for tumor extirpation and reconstruction. Advanced breast cancer today is incurable, and many prognostic factors can be used to try to predict a clinical course and response to therapy; however, no guidelines are available. Our case report most likely represents a metastasis to the calvarium with intracranial extension, reported to occur in about 3 percent of primary breast cancer patients. As demonstrated here, tumor ablation with immediate, one-stage reconstruction of large scalp defects is possible without the need for free tissue transfer or a delay in adjuvant therapy. Local tissue rearrangement has been employed for coverage of defects up to 50 percent of the cranium. The resulting donor defects can be closed with split-thickness skin grafts over pericranium. Serial tissue expansion and rearrangement can be used secondarily to replace skin grafts with hair-bearing scalp. Bony defects can be managed with either autogenous or alloplastic materials. Split-calvarial bone grafts can be harvested from the same operative field and cover small to medium-sized defects. Other sources of autogenous grafts include split ribs and iliac bone. Metals, calcium ceramics, and polymers such as methylmethacrylate can be used to cover intracranial contents and restore calvarial contour when defects are large or when autogenous material is not available. Palliation from tumor burden, prevention of pathologic fracture and oncologic emergencies, controlling pain, and enhancing quality of life are the goals of the oncologic and reconstructive surgeons in cases of advanced breast cancer. These goals are becoming even more important as new forms and combinations of chemotherapy, radiation, and gene therapy are extending the life expectancy of women with breast carcinoma.

Brachycephaly and external pressure.

Browsing through some literatures, I happened to find out some records on the rite of imitation of the child's head to brachycephaly. In 1976, two skulls showing extraordinary forms were excavated out of an ancient tomb at Yean village of Daedong township in Kimhae County in Kyungnam Province, the Republic of Korea. The deformation in Yean village is judged to be an intentional frontal flattening. The frontal bone of deformed individuals is remarkably flattened by a primary deforming force. The parietal bone expands laterally and superoposteriorly as a major compensatory growth. The lambdoid or occipital flattening induced by the counterforce is light and unstable. In the facial skeleton, the maxilla shifts downward as a minor compensatory growth. These findings might be substantially correspondent to the custom in the southern area of Korea in the 4th century A.D. paragraphed by Han chuan of Wei-dynasty record, History of the Three Kingdoms. It described that the people gave a pressure onto the child's forehead with stones in order to mold it for preference. Flatheaded meant "free" among the Chinook and Salish tribes of American Indians. Babies of slaves were denied the year-long beauty treatment--a board tied to the infants' padded skull--that permanently flattened the foreheads of tribal members. Referring to these records, I presume that brachycephaly can be induced by direct extrinsic pressure at least until the soft infant's head gets hard.