Elective trepanation for acute epidural hematoma by Dr. Nicolaes Tulp (1593-1674)

THE IMPROVED KNOWLEDGE of human anatomy in the 16th century led to an incre ase in the practice of cranial trepanation in clinical cases, and detailed definitions of indications for performing this operation were provided by s everal authors. It was not until the 18th century, however, that detailed d ata on patient selection, decision making, and the postoperative course of this surgical procedure became available through individual case reports. I n this historical context, a report written in 1641 by the Dutch physician Dr. Nicolaes Tulp is remarkable. This report, one of the first individual c ommentaries on the surgical treatment of an acute epidural hematoma, has no t yet gained international recognition.