The Sociopolitical History and Physiological Underpinnings of Skull Deformation

Amit Ayer, B.S.; Alexander Campbell, M.Phil.; Geoffrey Appelboom, M.D.; Brian Y. Hwang, B.A.; Michael McDowell, B.S.; Matthew Piazza, B.A.; Neil A. Feldstein, M.D.; Richard C. E. Anderson, M.D.


Neurosurg Focus. 2010;29(6):e1 

In This Article

Abstract and Introduction


In this report, the evidence, mechanisms, and rationale for the practice of artificial cranial deformation (ACD) in ancient Peru and during Akhenaten's reign in the 18th dynasty in Egypt (1375–1358 BCE) are reviewed. The authors argue that insufficient attention has been given to the sociopolitical implications of the practice in both regions. While evidence from ancient Peru is widespread and complex, there are comparatively fewer examples of deformed crania from the period of Akhenaten's rule. Nevertheless, Akhenaten's own deformity, the skull of the so-called "Younger Lady" mummy, and Tutankhamen's skull all evince some degree of plagiocephaly, suggesting the need for further research using evidence from depictions of the royal family in reliefs and busts. Following the anthropological review, a neurosurgical focus is directed to instances of plagiocephaly in modern medicine, with special attention to the conditions' etiology, consequences, and treatment. Novel clinical studies on varying modes of treatment will also be studied, together forming a comprehensive review of ACD, both in the past and present.


Nichter and colleagues[21] suggested that the idiom "heads of state" might have derived from the practice of the political elite's molding the heads of their offspring to differentiate themselves from the rest of a populace. Studies of human remains from ancient Peru and Egypt have not drawn attention to the political implications of artificial skull deformation, whether artistic or real. These perceptual or structural cranial characteristics can be derived from a variety of factors that will be elaborated upon throughout the course of this paper. First, physical evidence from ancient Peru and Egypt is reviewed. Second, the discussion draws attention to ways in which the politics of a society might help to explain the rationale behind ACD. Ancient Peruvian and Egyptian evidence suggests that physical or artistic manipulation of skulls was undertaken not just to reinforce social distinctions, but also to entrench political power. It is argued that approaching perceptions and portrayals of skulls could also complement discussions of artificially deformed crania. The techniques used in ACD will then be elaborated upon, with a discussion of the physiological basis, consequences, and treatments of plagiocephaly.


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