Trepanation for dementia

Trepanation, the ancient practice of drilling a hole in your skull to relieve pressure on the brain, is now being studied as a possible treatment for dementia. The effort is being led by Russian neurophysiologist Yuri Moskalenko, now at the Beckley Foundation in Oxford. Apparently, dementia may be correlated with cranial compliance, a measure of how cerebrospinal fluid circulates around the brain. If that system gets mucked up, the brain doesn't function well. From New Scientist (image from Wikimedia Commons):
 Wikipedia Commons 4 48 Plate 20 6 20 Extract 300Px Moskalenko studied 15 people who had undergone (trepanation) following head injuries. He found that their cranial compliance was around 20 per cent higher than the average for their age. Based on this, he calculates that a 4-square-centimetre hole increases cerebral blood flow by between 8 and 10 per cent, which is equivalent to 0.8 millilitres more blood per heartbeat (Human Physiology, vol 34, p 299). This, he says, shows that trepanation could be an effective treatment for Alzheimer's, and he even goes so far as to suggest that it might provide a "significant" improvement in the mental functions of anyone from their mid-40s, when cranial compliance starts to decline.
The Return of Trepanation


  1. That’s fascinating, and makes quite a bit of sense. However, it seems a bit extreme. It seems that performing daily headstands or using an inversion board would produce similar results.

  2. Being 41, I need that like a hole in the head.

    Thank you, thank you. I’ll be here all week. Try the veal.

  3. I’ve read that a lot of people that are diagnosed with alzheimers actually have too much fluid in their brain and they return to normal when the extra fluid is drained. Maybe that’s what’s going on here.

  4. Plus, when you push in the “4-square-centimetre” bone-free area with your index finger you get to smell burning toast. It’s win-win!

  5. I recommend this procedure only when required by the driving habits or political views of the demented.

  6. Interesting, I think that people should study more about this (but will be very hard to find a form of placebo for test)

  7. @ Tom Hale

    I’ve never heard that theory, and I know a lot about dementia.

    Interesting idea of trepanation. Still doesn’t help with neurofibrillary tangles and amyloid plaques which are the most common physiological correlates of dementia. Unless Moskalenko thinks trepanation would work as a prophylactic treatment – although neurofibrillary tangles start to accumulate around age 30. It also raises issues of consent – drilling a hole in the skull is a pretty invasive procedure for someone who has lost a reasonable portion of the marbles.

  8. I suppose I should have said, “too much fluid in their brain,” instead of increased intracrainial pressure. I suppose I’ve mixed the two since I read about it a few years ago.

  9. Please, please, please read the Wiki page on Amanda Feilding, and go ahead and read the ‘science’ projects at the Beckley Foundation’s website.


    Regarding the NPH treatment: it looks like the Dysmorphophobes, er, trepanatists have been drilling in the wrong place…

  10. I clicked on the comments to see how many of them it took before someone made the “I need that like I need a hole in my head” joke. (Of course, on the off chance no one made it, I was ready to do so.)

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