In Mexico, China, and Europe, archaeologists continue to find ancient human skulls with holes carefully drilled into them by a process called trepanation. Recent findings by Prof. Yuri Moskalenko, head of the Comparative Physiology of Circulation Laboratory in St. Petersburg, working in collaboration with Amanda Feilding, have shown that these holes may not have been the products of religious rituals as is commonly thought but, in fact, medical procedures. Over the past fifteen years, Moskalenko has developed an innovative imaging technique able to shed light on the potential medical benefits of trepanation in relation to brain activity.
The brain’s productivity depends on essentially three factors: blood flow, mobility of cerebral spinal fluid (CSF, which removes waste products from the brain), and the flexibility of the skull. As blood pressure increases with every heartbeat, the skull must have sufficient internal space to accommodate the increase in volume of blood. This space is created when the skull expands under the systolic increase in pressure as the pulse pushes blood into the head.
While blood flow can be measured in the brain, it was until now not possible to track it simultaneously with the movements of CSF and the expansion of the skull. Moskalenko has developed a technique to measure changes in these three parameters simultaneously. His research has shown that if the skull has reduced flexibility the blood supply and CSF mobility to the brain is diminished, thus impairing brain activity. Moskalenko has also shown that senile dementia and other age-related mental disorders of a vascular nature are more closely linked to a drop in CSF mobility than a decrease in blood flow.
For many people, the practice of drilling holes in heads is objectionable or simply barbaric. However, trepanation is an unavoidable consequence of some operations. Moskalenko found that when the holes in the skull were left open after an operation, the brain received a better supply of blood. He also demonstrated that an increase in the skull’s capacity of only 1-2ml invigorates the movement of CSF and ensures that the brain receives a more abundant supply of blood.
We have just completed the first phase of the research, and this has already yielded some exciting results and possibilities.
The major findings:
1) Trepanation acts to restore the elasticity of the cranial system to the healthy levels associated with youth. This is the result of an average 20% increase in the complex tensibility of the skull, leading to a change in the distribution of arterial and venous blood, as well as CSF, and ensures there is sufficient capacity to accept a pulse increase in arterial pressure (i.e. reduces the likelihood of an increase in blood pressure leading to an increase in intracranial pressure). It also leads to an increase in cerebral blood flow during the diastolic (relaxation) phase of the heart beat.
2) The pulse stroke volume (the volume of blood entering the skull with each heart beat) is almost doubled, leading to an 8-10% increase in cerebral blood flow. This means an 8-10% increase in the delivery of oxygen and nutrients and so the working capacity of the brain.
3) The pattern of CSF movement within the brain changes so it acts as a more effective deliverer of nutrients and remover of toxic waste products. This is due to a decrease in the volume of CSF flowing from the brain to the spinal cord, and an increase in the volume of CSF moving through its cranial compartments and into the sub-arachnoid spaces, from where it is drained. As one analogy puts it, if CSF acts as the brains washing machine, then Trepanation acts to turbo charge the machine. This increase in CSF mobility is of particular importance as various age-related disease states such as dementia and Alzheimers have been linked to a decrease in CSF mobility. So trepanation acts as a direct countermeasure to these changes. Moreover, at an earlier age, trepanation may act to prevent the development of Alzheimers by increasing the removal via the CSF of large, toxic beta-amyloid particles, whose accumulation is associated with the first stages of Alzheimers.
4) This change in CSF movement leads to an increase in the compensatory potential of the cranial system i.e. increases in blood volume or pressure have a lesser impact on increasing ICP as the CSF more easily absorbs the force of these changes.
5) The increased CSF movement also leads to an increase in the force with which venous blood drains from the skull, as more CSF movement leads to more pressure being exerted on the venous system, a further facet of improved cerebral circulation.
6) Trepanation increases the effect that external influences, such as respiratory movements, have on the cerebral fluid systems (blood and CSF) and so could be used in conjunction with other therapeutic techniques such as Yoga or meditation to further enhance the beneficial effects of these practices.
7) Perhaps most importantly of all, trepanation is safe to the extent that none of these changes exceed the normal limits of cerebral circulation.
These findings therefore open up the possibility of developing craniotomy as a therapeutic treatment for the significant number of diseases of the brain that result from disorders of cerebral blood or CSF flow, which result in disrupted oxygen distribution to brain cells. In the next phase of research we will continue our investigation into craniotomy, as well as explore the effects that deep breathing, Yoga and meditation have on the cranial system, to determine why these techniques have the effects they do, and what, if any, their therapeutic potential might be. We also hope to determine how the size and location of the trepanation hole influence the effects it has, as well as assess the effects of trepanation, if any, on cognitive functioning (and particularly the restoration of cognitive functioning in those suffering from age-related declines in these faculties).