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You Need It Like a Hole in the Head: The Ancient Medical Art of Trepanation

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If you had to guess, what do you think the oldest known surgical procedure might be? Maybe a Caesarean section? Amputation ? Appendectomy? It seems strange, but the surgery humans have been trying their hand at since Neolithic times is trepanation (also known as trephination or trephining) — the practice of drilling a hole in the skull to treat health problems related to intracranial diseases, to release pressure from a head injury or to provide an escape hatch for evil spirits.

Ancient Holes in the Head

Healing with holes, modern trepanation.

Now, you might not want a caveman cutting a hole in your head, and that's understandable, but it appears to have been a pretty popular pastime all the same.

"More than 1,500 trephined skulls have been found throughout the globe, from Europe and Scandinavia to North Africa, and from Russia and China to North and South America — particularly in Peru," says Dr. Miguel Faria, a medical historian and retired professor of neurosurgery in the Mercer University School of Medicine in Macon, Georgia, in an email. "Perhaps the greatest concentrations are found in the Eurasian landmass and South America."

Not only was this practice widespread, it seems knocking a hole in somebody's skull was all the rage in the late Neolithic — about 4,000 to 12,000 years ago. In fact, if you take all the skulls from this period, collected from around the globe, between 5 and 10 percent of them have a hole in them, made while the person was still alive. These skulls most commonly belonged to men, but women and children were not excluded from the procedure. The holes were definitely purposeful, and sometimes the owners of these skulls seemed to have survive the procedure, at least for a while.

The big question is, why ?

According to Faria, although we can't see into the minds of primitive medical practitioners, trepanation seems to have been a go-to remedy for a variety of maladies — perhaps by shamans in order to "cure" or alter behaviors or mental illness. In his 1995 book " A History of Medicine – Volume I: Primitive and Ancient Medicine ," medical historian Plinio Prioreschi suggested cranial surgery was performed on important members of society or hunting groups in order to resuscitate them during a grave illness or after sustaining a wound.

The ancient Roman medical practitioner Hippocrates, and later Galen, wrote about trepanation as a means of removing damaged tissue and elevating depressed skull fractures, but reasonably cautioned against penetrating the dura mater — the thick membrane that encases the brain — or the brain itself, as they noticed it resulted in serious complications, such as infection, seizures and often death.

"The Romans used instruments called terebrae that resembled the more primitive tumis of the Incas," says Faria. "The terebra in turn was the forerunner of the modern burr hole manual drill. During the Middle Ages and the Renaissance, trepanation was performed not only for skull fractures but also for madness and epilepsy. A famous painting by Hieronymus Bosch depicts the extraction of the stone of madness."

In the European medical tradition, trepanation was mostly practiced in the treatment of epilepsy and mental illness, like mania and melancholy. One 13th-century surgical text recommended drilling into the skulls of epileptics so "that the humors and air may go out and evaporate." Four centuries later, trepanation was beginning to be viewed by the medical community as a last resort.

The history of trepanation, or trepanning, is obviously long, but it's important to note that doctors still practice it today for a variety of different ailments, although they don't call it "trepanation" anymore — that's just a term used by medical historians. These days, "burr holes" are made in the skull in order to biopsy brain tissue or diagnose brain lesions, treat skull fractures, remove brain tumors or clip cerebral aneurysms. When the hole is enlarged, it's called a "craniotomy."

According to Faria, although no remote areas of the world have remained free of Western influences, rudimentary trepanations are still carried out by shamans in parts of Africa, as has been witnessed and video-recorded by journalists in remote villages. These are purportedly done to remedy skull fractures.

Trephining was widely practiced in Europe between the Renaissance and the beginning of the 19th century as a treatment for head wounds.

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Craniotomy - series—Procedure

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The hair on part of the scalp is shaved. An incision is made through the scalp and a hole is drilled through the skull. A piece of the skull may be removed while the brain is being operated on and replaced before the skin is stitched closed. The surgery in which the brain is accessed through the skull is called "craniotomy".

Review Date 1/18/2023

Updated by: Luc Jasmin, MD, Ph.D., FRCS (C), FACS, Department of Surgery, Johnson City Medical Center, TN; Department of Maxillofacial Surgery at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Related MedlinePlus Health Topics

• Brain Aneurysm
• Brain Diseases
• Brain Tumors
• Childhood Brain Tumors
• Hydrocephalus

Tom Clancy's Ghost Recon® Wildlands

Originally posted by Legatus Lucanus : the rainbow six pack which contains the balaclava it sounds that you are looking for is offerd right now in the daily changing secition of the store. just in case you still want it. :)

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Rainbow Six Equipment (Ghost Pack)

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“ Get ready for Operation 2 with this exclusive equipment set inspired from Rainbow Six ® Siege. - In-game Description ”

The Rainbow Six ® Equipment pack is a Ghost Pack in Tom Clancy's Ghost Recon Wildlands . It contains 7 items from Tom Clancy's Rainbow Six: Siege. Below is the full list of the items, including the price, where to find the items in the customization screen, and a gallery of what every item looks like.

Price: 1,900 Credits

Items Included :

• Caveira - Icons
• Luison - Pistols
• 416 - Assault Rifles
• 1 Hole Skull Balaclava - Accessories - Facewear
• Wrapped Shemagh - Accessories - Facewear
• The Plan - Voice Lines
• Eye on the Prize - Emotes

Gallery [ ]

• 2 Tom Clancy's Ghost Recon Breakpoint
• 3 Cole D. Walker

Tom Clancy’s Ghost Recon® Wildlands Guide

Tools of War – “The Ghost Bible”

Best-in-Slot Weaponry, SniperScopes -Rating, Drones, Tactical Items, CQC-Moves incl. Karambit, Nightvision, Costumes / Icons, Vehicles, ..and how to get it ..Links to specific Guides ..max-Weapons Gallery ..all Achievements

BiS -Gear (Silent) –> Rifle SLOT 1/2

Those are the best-in-slot options, if you have all Attachments.. and play Tier1-mode (Extreme). (.. In case you look for the Map-location, other weapons or detailed Stats.. check -> Links below) # = ideal range // {FG} = FallenGhosts DLC

#SNR (good Range, few Shots to kill Vehicles, secure kills vs Soft-Targets) 1. DesertTech HTI ***** ..-> Tier40 Reward (ranged Bazooka – precise, but slow RoF) 2. BFG-50A {FG} **** (slightly less dmg than HTI, but best RoF + customizable) 3. HTI **** (great Anti-Vehicle-Rifle, but slow RoF ..->TAC50=reskin) 4. Extranjeros BFG {FG} **** (high precision + best RoF ..Dmg-Tradeoff) 5. HTI MuddyBones {FG} *** (superior accuracy, but slow RoF ..also Dmg-Tradeoff) 6. *** : SR-1, SR SA 1 (SA=short version; solid Allrounder ..SRSA1 = better MSR) 7. TAC50 *** ..-> STORE-only ..HTI reskin with more bullet-drop ..-> disappointing weapon ;((

8. MSR ** (decent Allrounder vs Soft-Targets.. OK before you get the above) 9. * : M40A5, L115A3 (better grab the above) 10. FRF-2 ..-> Battle-Crates only ..worst sniper (with extreme bullet drop)

top crops: 1. 416 ***** ..-> STORE or BattleCrate (the better M4, longrange MK18 ..butterknife^^) 2. MK18 ***** ..-> STORE-only (strong as the LVOA-C BadNews, but better overall ..deadly^^) 3. LVOA-C **** ..-> Tier5 Reward (best in class, better R5 ..BUT nervous aim EXPS3 +G33) 4. TAR-21 **** (best vanilla Allrounder from 10-200m, like MDR, but slightly better Handling) 5. MDR **** {FG} (no.1 starting weapon, ..FG-owners might never need any other ASR) 6. ACR **** (great alternative instead of TAR-21/MDR, #rank 1 Compact weapon) 7. G36C **** ..-> UBI-Club (great Allrounder, the better M4 ..sadly, FoldedStock is Store-only ) 8. AK-12 **** {FG} (another ACR – reskin?)

solid: 9. R4 **** {FG} (top ranged ASR, BUT lower RoF + Handling) 10. R5 RGP **** (strong ranged ASR, BUT lower RoF + Handling ..the better MK17/AUG) 11. AUG A3 **** (solid alternative instead of TAR-21/MDR ..RoF subpar in CQC) 12. SC 4000 **** (solid Allrounder, #rank2 in Handling, weak at 200m+ ..-> Year2Pass ) 13. M4A1 **** (on par with SC4000: better RoF, But lower Handling)

average: 14. MK16 *** ..-> STORE-only ..MK17-reskin.. slightly better precision 15. MK17 *** (strong ranged ASR, BUT low RoF + bad Handling can result in quick Death) 16. Bren A2 *** (basically M4 with lower RoF ..modified: good 50Shot-SMG with GL) 17. SR3M *** (high RoF + solid punch on par with AugA3, BUT weak long-range) 18. AK-47 *** (on par with Bren: ..good dmg, BUT low RoF + bad Handling + Spread) 19. 556xi *** (a worse SR3M: ..low RoF + bad Handling)

not suggested: 20. ** : LVOA (buggy: the better R5, but no punch ..disappointing STORE -weapon!) 21. ** : F2000 (warning: P90 reskin with 30Mag + NO GL ..disappointing STORE -weapon!)

solid: 7. 9×19 VSN *** (on par with MP7, low RoF ..wrong stats, better than MP5) 8. PDR *** {FG} (solid Allrounder with low RoF) 9. MP5 ** (high RoF + good Handling, BUT weak dmg /penetration)

special usecase (#10-100m): 10. Vector .45ACP ** (solid + very high RoF, BUT lacks penetration ..superceeded by UMP45) 11. PP19 ** (early/mid-game option, ..poor man´s P90 sporting a 64 Mag and solid punch) 12. SR635 ** (high dmg, BUT bullet drop is your enemy) 13. Honey Badger ** ..-> STORE-only (a worse PP19 ..disappointing STORE -weapon!)

BiS -Gear (Silent) –> Pistol SLOT 3

Unique Weapons (special design)

Smart observers have already seen that there is no* preconfigured weapon from Crates.. why? (*EDIT: after 600 hours I got the RevSG12 Shotgun, which is indeed a better SASG) (*EDIT 2: after 800 hours I got the Vector Spectra, which is slightly better than standard Vector) well, most fixed weapons are worse than fully adjustable ones.. not to mention a real lack of Suppressors. The same goes for most Quest-Rewards besides LadyKiller Handgun.. yes, sad. A real Ghost in the shoes of SamFisher (SplinterCell) or the GhostRecon-team can take out a fortified Base by himself, but it will not work if you run guns-blazin through the front door..

Scopes (Overview +Rating)

Best LONGRANGE Sniper (SNR+ #300-600m)

It´s quite obvious that “FallenGhosts” introduced some new alpha-tier weaponry, which reduced skill-requirement. Be warned, it will mess up your skill with regular weapons ;((

Best ANTI-VEHICLE Weapons

Best COMPACT Weapons

• ACR* a better P90 with GL ..also proving F2000 (Store-only ASR) obsolete LOL
• G36C most compact ASR ..the girls´ bazooka (folded stock ->STORE pack)
• AK-12* solid option, but looking too long
• SR3M solid package, but lacks ranged punch
• Bren A2* decent Allrounder
• AK-47* ok, but looking too long
• 556xi* average, but looking too long

* 50Shot Mag. available

“Loud-only” Weapons (with solid Performance)

• SNR: – KSVK ..-> BattleCrate only (#rank4 ..similar to HTI, but bullet drop sucks) – M1891 (#rank6 ..similar to SR1) – SR25 Jungle (glitched aka OP ..1hit @1km Range + high RoF -> “Click & Destroy”)
• ASR: – SIG556 Llama (strong, BUT no grenade launcher) – Extranjeros MDR (strong, BUT no grenade launcher)
• LMG: – M60E4 (extreme Anti-Vehicle-Weapon, also good at range) – Unidad RPK-74 (best LMG to fight an army ..weakness: 150m+ precision) – MK48 (good dmg + high RoF, BUT Spread needs training ..best vanilla LMG) – 6P41 (on par with RPK-74, BUT Handling is bad.. keep targets 100m+ -> precision is good)
• SMG: – 9mm C1 (34 Mag, high dmg + Sten-gun sound ..spread is a downside)
• STG: – El Obsequio (good Shotgun ..best SPAS12 ..deadly within 60m) – M1887 ..-> BattleCrate only (solid Shotgun ..on par with SPAS12 ..deadly within 50m) – El Cuentista (glitched aka OP ..128m Range..1shot vehicle kills)
• HDG: – BFF (7 Mag + decent RoF, BUT spread is your enemy ..-> best Anti-Vehicle-Handgun) – D-50 (high dmg, BUT low RoF + small 7 Mag ..still destroys vehicles within 7 shots) – .357 Joker (high dmg, BUT low RoF + only 6 Shots ..-> can´t kill vehicles without reload)

Where to “find” ..?? (Locations, STORE)

I´ve listed the info you need to aquire all the weapons (plus special items) you can “find” in WILDLANDS.. (note: several great weapons are mission-rewards.. and some are SHOP-only, which requires farming Credits via Daily Challenges.. or invest real money to save some hundred hours^^)

MAIN Story: ..check below (scroll down) .. ->Links (<– or click here)

Ghost -Mode (Permadeath) – 100% Security -> Exoskeleton Boots – 100% Influence -> Exoskeleton Armor – 100% Smuggling -> Exoskeleton Pants – 100% Production -> Exoskeleton Backpack – El Sueno -> Exoskeleton Mask

Guerilla -Mode (Coop: Defend vs Waves) – complete 1 game -> Survivor Pants + Survivor T-Shirt

Mercenaries -Mode (8 player PvPvE) – dead – complete 1 match -> LoneWolf -Outfit (Walker) – win 3 matches -> Mercenary Jeans – win 5 matches -> Mercenary Vest – win 10 matches -> Mercenary Jacket – win 15 matches -> Mercenary Heavy Vest – win 25 matches -> Mercenary Backpack

..the following items must be bought in STORE.. via real money (or farming endlessly until you have most items and receive blue Store-credits for any doubles you find..)

• ASR: Mk18 , MK 16 , LVOA , F2000, ( 416 ..wrong, can also be aquired from Crate ^^)
• SMG: HoneyBadger
• STG: M4 Super90 , ACS-12
• Paint Presets: KT (Banshee/Neptune/Raid), White, Copper, Titanium, Aluminium, Tigerstripe
• ..for many more: check “->Store Packs” below

..the following items are exclusive to “Digital Deluxe Pack” , which shipped via Deluxe-Edition and classic Gold-Edition

• Wilderness (Shotgun included with Huntsman-Gearset)
• Paint Presets: KT (Mandrake/Nomad/Yeti)
• Huntsman-Gearset (Sunglasses, Jacket, Pants)

..exclusive items granted by SeasonPass (Year1)

• SNR: ChicaMala (Mission-Reward “Peruvian Connection” ..-> SeasonPass or PreOrder)
• ASR: ElCommandante (Mission-Reward “Unidad Conspiracy” ..-> SeasonPass or Uplay-Club)
• LMG: Unidad RPK-74 (-> “loud”, but the best LMG by a mile.. DukeNukem approves^^)
• HDG: M1911 Golden
• Costums: RebelLeader, Unidad, SantaBlanca

list of exclusive weapons..

• ASR: AK-47 Undercover , AK-47 Uprising

Only the following FG-weapons can be found directly..

• HTI MuddyBones
• Extranjeros (BFG / MDR / R4 / PDR)
• 556xi Dragon
• L85A2 Crocodile
• SR635 Apparition
• Phobos Crossbow

Deimos Crossbow – Major Rocha mission

• #SNR: PSG-1 – Captain Cruzar mission PSG-1 Mercenary – Ubisoft Club BFG-50A – Intel mission (Western Precinct) SR-25 Jungle – Headhunter (Rebel Skill: Spotting) Mk14 Occult – Tower Cast (Rebel Skill: Vehicle Drop-Off)
• #ASR: MDR – Intel mission (Eastern Precinct) R4 – Captain Ortega mission
• #LMG: T95 Spectre – Sabotage (Rebel Skill: Guns for Hire)
• #SMG: PDR – Intel mission (Northern Precinct)
• #HDG: Scorpion Skull – Save the Rebel VIP (Rebel Skill: Diversion)

STORE-Packs (best value!)

in progress.. STORE ->Featured Content ->… STORE ->Time-Limited Offers ->…

• Frontline: (..2600Credits) incl. M110 , MK16 , Armored Pants + Vest + HeavyVest, Tigerstripe (WeaponPaint)
• Gladiator: (..1900Credits) incl. P90 Mirmillo (SMG), SPAS Secutor (STG), Warrior Pants + Vest + ArenaMask , 2 Tattoos (Honoris, Morituri)
• Warrior: (..1500Credits) incl. Tracker Pants + Vest, Warrior Pants + ArenaMask , “Sun´sOut?..”-Jacket, 3 Facepaints (incl. WhiteHand), 3 Tattoos (Wolf, Honoris, Morituri)
• Military: (..1500Credits) incl. Commando Pants + Jacket + Shoes, Warrior Vest , Military Beret , WWII SteelPot, 2 Tattoos (Liberator, Ranger), DoomMask
• Rainbow Six Equipment: (..1900Credits) incl. Caveira (Outfit), Luison (HDG), 416 (ASR), 1-hole Skull Balaclava, Wrapped Shemagh,..
• Challenge Rewards: (..1600Credits) incl. SonarGoogles (best Nightvision), BallisticMask, DayOfTheSkull Mask, Wool Beanie, Broken ElTio Mask, Skull Sunglasses, 22 Patches (CommandoSkull, FourthEchelon, Caveira, Valkyrie, ElTio, ElYeti, Snake, AngelWings, etc), WeaponPaints: Bronze, DarkBronze, KT Highlander
• Civil War: (..800Credits) incl. Blue Uniform + Cap + Musket (SNR) + Peacemaker (HDG)
• LastChance: (..1500Credits) incl. .357 Joker (HDG), Stampede (Cowboy ASR), Cowboy Hat + Boots, BomberJacket
• Silent: (..) incl. LeatherJacket, round Sunglasses, SRSA1 BlackWidow (SNR) + Whisper (HDG)
• Drilling: (..1200Credits) incl. Thermite TankTop +Pants +Thermite Shoes (Sneakers) + MSR Thermite (SNR)
• Veteran: (..1200Credits) incl. WWII SteelPot + VeteranBren (LMG) + Luger (HDG)
• Yeti Hunter: (..) incl. YetiHunter (Costume) + IceShard (STG)
• Doorkicker: (..1900Credits) incl. T-shirt + Sneakers + DoomMask + P90 Doorkicker (SMG) + SMG11 Dragon (HDG)
• Tiger: (..) incl. traditional Pants + Bandana + + MK17 TigerFang (ASR)
• Los Extranjeros Camo: (..500Credits) incl. WeaponPaints: CovertOps, LosExtranjeros, CarbonFiber, Militia, Elite, Cheetah
• Jungle Storm Camos: (..800Credits) incl. WeaponPaints: Pencott GZ + BL, Amphibian, Snake, Germania Intense, Canadian Green
• Facial Paints: (..500Credits) – incl. 30 major country flags
• G36C: Folded Stock (STORE ->Weapon Packs ->Stocks …520Credits)
• Crye Combat Shirt 2 (STORE ->Time-Limited Offers ->…)

*important items listed

note: most Packs come with special Patches, that are hard or impossible to aquire otherwise.. Personally, I hate paying 1-2 weeks worth of Credits (Daily Grind^^) just to get another 1-3 Patches for your Backpack. But truth is, even ~900 hours in this game I miss Patches that seem to be “locked” behind those Packs I didn´t aquire yet ;(( -> I would strongly suggest to make this your last goal.. if ever. (Should be said there is no Completionist achievement for this..)

Special Devices (Drone, Items)

– Diversion Lure (max: 11 / AoE: 17,5m) ..-> perfect to split up enemies – C4 (max: 6 / AoE: 5m) ..-> remote detonation makes it perfect for Ambush – Mine (max: 6 / AoE: 6m) ..-> great, but Civilians/Allies tend to get killed – Frag Grenade (max: 8 / AoE: 5m) ..-> useful against groups/vehicles, but requires practice – Flash Grenade (max: 6 / AoE: 15m) ..-> required to melee 2 targets in row or headshot a group – Flare Gun (max: 7 / AoE: 300m) ..-> draws everything, don´t drop it near you – Proximity Mine (max: 3 / AoE: 5m) ..-> quite useless

Special CQC-Moves (Executioner, Caveira, Echelon)

• Executioner Wristband – intense Knife Stabbing , a lot of variety, but draws out melee combat -> Operation: Oracle (Walker) Reward
• Caveira Gloves – push enemies to the ground, while Slitting Throat and recon nearby targets -> Operation: Archangel (Caveira) Reward
• Echelon Gloves – SplinterCell style using Karambit, while keeping enemy in front of you ( fastest ) -> SplinterCell pack included with Year2Pass

Superior Nightvision (SplinterCell)

note: Sonar Googles can be aquired separately, but takes time..

Costumes + Icons

° = Uplay-Club // ^ = SeasonPass (Year1)

• °GR: Future Soldier
• °The Division
• °Assasin´s Creed
• °Splinter Cell
• °Dying Earth
• Yeti Hunter
• Santa Muerte
• ^Rebel Leader
• ^Santa Blanca
• Airforce Uniform
• Marine Uniform
• Navy Uniform
• Gorka Outfit
• Lone Wolf (-> “Mercenaries”-mode)

# = STORE-only

• ScottMitchell
• Santa Blanca
• Carl Bookhart

Skull Suppressor (cosmetic)

• Tac 50 (HTI reskin)
• MSR EagleShot

Best Vehicles (obtained from Crates)

*= high mobility °= strong armor

[link] [link] [link]

Weapons Gallery (Tiermode – max.)

Keep in mind that several weapons perform very different from their ingame-Stats

Achievements (UbisoftConnect)

Here is a list of Achievements you might like, but it´s only shown in Uplay (UbisoftConnect). Steam does not import/inherit your Achievements, but you also get everything via STEAM^^ There are 14 more for DLCs (7x NarcoRoad + 7x FallenGhosts), but nothing breathtaking.