> let blood by perforating with a small trepan Trepanation makes really good sense for epidural hematomas. Epidural hematomas are bleeding that occurs between

> let blood by perforating with a small trepan Trepanation makes really good sense for epidural hematomas. Epidural hematomas are bleeding that occurs between the skull and the dura which is the tough outer covering of the brain. This can happen from trauma. When that happens blood flows into the space between the dura and the skull and starts building up there. Eventually the pressure will build up and the blood will start pushing the brain. If this continues, the blood will build up enough to push the brain out through the base of the skull. This is called brain herniation, and is fatal. Natasha Richardson, Tony award winning actress and Liam Neeson's wife, died several years ago from this type of bleed. An epidural hematoma would be perfect to treat with a trepan. One of the big risks of trepanation is that you pierce or tear the dura during the operation, which will cause cerebro-spinal-fluid (the fluid around the brain and spine) to leak and can introduce bacteria that cause meningitis. With an epidural hematoma that is less likely, because the blood has built up under the skull and pushed the dura down, leaving a cushion of blood there. This makes it less likely for you to injure the dura. The results likely would have been spectacular for the ancient practitioner. The patient would initially be increasingly sleepy their eyes would be fixed looking to one side. When the bone was cut out and removed, there would be a bunch of blood that drained out, and the patient would rapidly improve as the pressure on the brain was relieved. Source: Trained in Neurosurgery