Department of Neurology and Psychiatry, Neurosurgery, "Sapienza" University of Rome, Rome, Italy
Department of Medical-Surgical Sciences and Biotechnologies, Neurology Unit, Ospedale "A. Fiorini" Terracina, LT, "Sapienza" University of Rome, Polo Pontino, Rome, Italy.
Neuroscientist. 2015 Jun;21(3):322-8. doi: 10.1177/1073858414559252. Epub 2014 Nov 17.
In Egyptian, Greco-Roman, and Arabic medicine, the closure of a skull defect was not provided at the end of a therapeutic trepanation or in cases of bone removal. The literature from the Middle Ages and Renaissance disclosed some striking and forgotten practices. Gilbertus Anglicus (c. 1180 to c. 1250) cites the use of a piece of a cup made from wooden bowl (ciphum or mazer) or a gold sheet to cover the gap and protect the brain in these patients; this citation probably reflected a widely known folk practice. Pietro d'Argellata introduced the use of a fixed piece of dried gourd for brain protection to reconstruct a skull defect. In the late Renaissance, the negative folklore describing this outlandish practice likely led to the use of silver and lead sheets. Nevertheless, for centuries, large numbers of surgeons preferred to leave the dura mater uncovered after bone removal, and failed to apply any brain protection.
在古埃及、希腊罗马和阿拉伯医学中，颅骨缺损的闭合并非在治疗性环锯术结束时进行，也不是在去除骨块的情况下进行。从中世纪和文艺复兴时期的文献中可以发现一些引人注目的被遗忘的做法。英国的吉尔伯特（约 1180 年至 1250 年）引用了使用木制碗（ciphum 或 mazer）或金片的一块来覆盖缺口并保护这些患者的大脑；这一引文可能反映了一种广为人知的民间做法。皮埃特罗·达加莱塔（Pietro d'Argellata）引入了使用固定的干葫芦片来保护大脑以重建颅骨缺损的方法。在文艺复兴后期，负面的民间传说描述了这种古怪的做法，可能导致了银和铅片的使用。然而，几个世纪以来，大量的外科医生更愿意在去除骨块后让硬脑膜暴露在外，而不采取任何保护大脑的措施。
