Editing Trepanning (section)

== Risks ==
A [[Neurosurgery|neurosurgeon]] can perform the procedure safely, although it comes with severe repercussions such as direct or indirect perioperative complications, which include increased damage to the brain, infection, blood loss, hemorrhage, and potentially death due to the trauma as the skull's protective covering is compromised.<ref>{{Citation|last=Nikita|first=Efthymia|title=Chapter 8 – Pathological Conditions|date=2017-01-01|url=http://www.sciencedirect.com/science/article/pii/B9780128040218000085|work=Osteoarchaeology|pages=301–54|editor-last=Nikita|editor-first=Efthymia|publisher=Academic Press|doi=10.1016/B978-0-12-804021-8.00008-5|language=en|isbn=978-0-12-804021-8|access-date=2020-05-05}}</ref> The operation leaves very minimal space for error and a high incidence of mortality if the dura mater is penetrated. Additionally, there is a high risk of infection if the operation is conducted with contaminated tools or improper sanitary wound care.<ref>{{Cite journal |date=2000-03-04 |title=Doctors warn of the dangers of trepanning |journal=British Medical Journal |volume=320 |issue=7235 |page=602 |issn=0959-8138 |pmc=1173790}}</ref> If the infection is not caught and treated immediately, it can be fatal or lead to significant and permanent brain damage. After surgery, neither the surrounding bone nor the trepanned bone piece ever show any osseous healing like other bones. Osteoclastic and osteoblastic activity occurs after the first week; [[Hyperaemia|hyperemia]] and [[osteoclast]]ic activity are seen on the necrotic bone surrounding the trepanation site, due to loss of blood supply.<ref>{{Cite journal |last1=Rungta |first1=Ravi L. |last2=Chaigneau |first2=Emmanuelle |last3=Osmanski |first3=Bruno-Félix |last4=Charpak |first4=Serge |date=2018-07-25 |title=Vascular Compartmentalization of Functional Hyperemia from the Synapse to the Pia |journal=Neuron |volume=99 |issue=2 |pages=362–375.e4 |doi=10.1016/j.neuron.2018.06.012 |issn=0896-6273 |pmc=6069674 |pmid=29937277}}</ref><ref>{{Cite journal |last=Knüsel |first=Christopher |date=March 2004 |title=Trepanation: History, Discovery, Theory. R. Arnott, S. Finger & C.U.M. Smith (eds). Swets & Zeitlinger Publishers, Lisse, The Netherlands 2003. 408 + XIIpp. ISBN 90 265 1923 0. £67/$99 |url=https://onlinelibrary.wiley.com/doi/10.1002/oa.703 |journal=International Journal of Osteoarchaeology |language=en |volume=14 |issue=2 |pages=151–153 |doi=10.1002/oa.703 |issn=1047-482X}}</ref>