Trephination

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Trepanation (also known as trepanning, trephination, trephining or burr hole) is surgery in which a hole is drilled or scraped into the human skull, thus exposing the dura mater in order to treat health problems related to intracranial diseases, though in the modern era it is used only to treat epidural and subdural hematomas and for surgical access for certain other neurosurgical procedures, such as intracranial pressure monitoring.

Trepanation was carried out for both medical reasons and mystical practices for a long time. Evidence of trepanation has been found in prehistoric human remains from Neolithic times onwards. Cave paintings indicate that people believed the practice would cure epileptic seizures, migraines, and mental disorders perhaps in the belief to cure diseases by letting evil spirits escape. The bone that was trepanned was kept by the prehistoric people and worn as charms to keep evil spirits away. Evidence also suggests that trepanation was primitive emergency surgery after head wounds to remove shattered bits of bone from a fractured skull and clean out the blood that often pools under the skull after a blow to the head. Such injuries were typical for primitive weaponry such as sling shots and war clubs.

The modern medical procedure of corneal transplant surgery also uses a technique known as trepanning or trephining. This operation, however, is conducted on the eye (not the skull), with an instrument called a trephine.

The procedure of drilling a hole through a nail is also known as trephination. It is performed by a physician or surgeon to relieve the pain associated with a sub-ungual hematoma (blood under the nail); a small amount of blood is expressed through the hole and the pain associated with the pressure is partly alleviated.