The evidence of trepanation comes primarily from archaeological sites, where skulls with clear signs of trepanation have been uncovered. Some of the most famous sites include:

• The Pre-Columbian Americas: In regions such as South America, evidence of trepanation has been found among ancient civilizations such as the Incas and their predecessors. Many skulls have been found with holes made using stone tools, and the healing process observed in the bone suggests that these individuals survived the procedure.
   

• Ancient Europe: Trepanation is also well-documented in prehistoric Europe. For example, Neolithic skulls found in France, Spain, and Ireland often show signs of trepanation. These skulls, dated to around 4,000–3,000 BCE, indicate that the practice was widespread across early European cultures.
   

• Africa and the Middle East: Trepanation was practiced in North Africa and the Middle East as well, particularly among early African and Mediterranean peoples. In Egypt, ancient skulls have been found showing signs of surgery that suggest an understanding of the need to treat head injuries.
   

• Ancient Asia: Evidence of trepanation has also been found in ancient China and parts of Southeast Asia. This suggests that the procedure was part of medical practices across many different cultures and was not confined to any one region.
   

How Was Trepanation Performed?

The process of trepanation varied depending on the culture and tools available. In some instances, stone or flint tools were used to scrape away bone, while in others, metal tools were employed. The hole could be small or large, and the procedure might involve removing a portion of the skull completely or just making a small perforation.

In certain cases, trepanation was performed by making an incision in the scalp and then using a tool to cut through the bone. The procedure was carried out without anesthesia, and the patient would likely have experienced intense pain during and after the operation. In some instances, evidence suggests that the patient was restrained to prevent movement during the procedure. shutdown123