Universiteit Leiden

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Picking Holes in Previous Approaches to Cranial Porotic Lesions

Wednesday 30 January 2019
Van Steenis
Einsteinweg 2
2333 CC Leiden

Porotic lesions of the orbital roof and cranial vault, often referred to as cribra orbitalia and/or porotic hyperostosis, are commonly found in archaeological human remains. For many these lesions have become synonymous with anemia (specifically iron deficiency), but debate on the causes and possible links between such lesions has continued for more than 30 years.

The research reported here set out to investigate the potential of using the ‘biological approach’ to paleopathological diagnosis, used by Don Ortner and recently proposed more formally by Simon Mays, to investigate porous cranial lesions and evaluate links between lesion types. Published biomedical information on conditions that might result in the development of porous cranial lesions was evaluated. For all conditions the sequence and types of physiological changes were considered alongside potential co-occurrence; for anemia age-related changes in the normal distribution of marrow type and potential for conversion and re-conversion reported in the literature were reviewed. 

A wide range of conditions with the potential to produce porous lesions of the cranial bones were identified, but combining careful evaluation of structural aspects of lesions found across the skeleton with biomedical information on marrow type and patterns of conversion with age were found to assist in suggesting a diagnosis. Results from this study show that in many cases if the ‘biological approach’ to paleopathological diagnosis is adopted it may be possible to suggest conditions involved in the development of porous cranial lesions.


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