Trephination is when a hole is cut into the skull, most likely for medical purposes.  There were different techniques used to perform this operation depending on the location and time period.  Photo A is of a trephination with no healing; due to the crudeness of the cuts and the multiple times the operation was performed this may have been a skull of an already deceased person that was used for practice.  The cranium comes from Lupo, Peru.  Photo B is another multiple trephination, but this time there is evidence of bone reaction indicating that the person was alive at the time.  The cranium is from Cinco Cerros, Peru.


Photo courtesy of Merbs, p. 180


 
 

A.  There is little to no evidence of healing after this trephination was performed.  This technique of trephination is the scraping or abrading one.  The cranium originates from Lovosice (Neolithic time period), Czech.
B.  This is also a photo of a complete trephination with no healing, but the technique used this time was a  straight cut. This cranium comes from San Damian, Peru.


Photo courtesy of Merbs, p. 179