Trepanation, or drilling a hole in the skull, is an ancient medical treatment getting a new look for the treatment of some mental illnesses, including dementia. The Beckley Foundation in Oxford has been seriously trying to use trepanation to treat dementia caused by Alzheimer’s or other reasons. The theory is that a hole in the skull improves blood circulation in the brain. Just what role blood circulation has in causing dementia is unknown.
However, trepanation for dementia is still mostly uncharted territory. A lot of the current literature about it is only in the theoretical stages. Drilling a hole in the head, properly called a craniotomy, is still used to treat brain hematomas and other necessary brain surgeries.
The main problem in using trepanation to treat any mental illness is that it sounds like a lobotomy or leucotomy. Popular movies like One Flew Over the Cuckoo’s Nest (1975) and Frances (1982) portrayed lobotomies as akin to legalized torture. Very few patients would volunteer for such a radical surgery. Lobotomies and other psychosurgeries have never completely disappeared from neuroscience, but they are still used as a last ditch treatment.
Another problem is that a trepanation is surgery. No surgical procedure is 100% safe. Complications can arise from blood loss, not being able to tolerate anesthesia and from infection. Opening the skull, even for a brief time, exposes it to any bacteria, virus or other material. The membranes around the brain, the meninges, can be become infected and a potentially deadly case of meningitis can develop.
Many people have voluntarily submitted or performed their own trepanations. One of the most famous was Amanda Fielding, who used a dentist’s drill to put a hole in her head. She even filmed the process and released the film under the title Heartbeat in the Brain (1970). She ran for Parliament with the promise to bring free trepanations to the general public but was not elected. She never publically regretted her decision to drill a hole in her head.
She got the idea from her mentor, Dr. Bart Hughes, who argued that since babies are born without a closed skull, adults shouldn’t have one either. A hole in the head was therefore the path to higher consciousness. Hughes used an electric drill for his own operation. The self-trepanation fad never quite disappeared. But a study has not been done to show if people with a hole in their skulls avoid dementia for the rest of their lives.