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Letter to the Editor

Brain vessels mummification in an individualof ancient Egypt

Albert Isidro a,b,*, Luis M. Gonz�alvez b and Adri�a Arboix c

a Orthopaedic Surgery Department, Hospital Universitari Sagrat Cor, Barcelona, Spainb Museu Egipci de Barcelona, Barcelona, Spainc Neurology Department, Hospital Universitari Sagrat Cor, Barcelona, Spain

a r t i c l e i n f o

Article history:

Received 10 July 2014

Reviewed 8 August 2014

Revised 20 August 2014

Accepted 10 September 2014

Published online 19 September 2014

* Corresponding author. Orthopaedic SurgerE-mail addresses: aisidro.cot@gmail.com

http://dx.doi.org/10.1016/j.cortex.2014.09.0050010-9452/© 2014 Published by Elsevier Ltd.

1. Introduction

The organs of the Central Nervous System are among the first

organs to undergo postmortem autolysis. Their preservation

is an unusual finding in ancient burials except those in which

the adipocere formation or conditions of extreme-dryness

leads to a different rate of preservation (Aufderheide, 2003).

Perhaps the best-known feature of Egyptian mummifica-

tion is the removal of the brain. Herodotus specifically men-

tions excerebration as part of the most elaborate of

mummification rituals, restricted to the elite. In anthropo-

genic or artificial mummies the brain had been removed by

different techniques using wire-like instruments and later

superseded the calvarium by preservative substances,

meningeal covering has been seldom found. This is due to the

fact that few remains of brain tissue survive the first step of

the procedure; the trans-ethmoidal extraction of the brain and

the subsequent introduction of resin-like substances

completed the damage of neural tissue.

Since 2006 a Spanish/German mission of the Egyptian

Museum in Barcelona and the Eberhard Karls University in

y Department. Hospital U(A. Isidro), aarboix@hsco

Tubingen has been working in the Necropolis of Sharuna,

Middle Egypt. This vast necropolis covers the period from the

beginnings of the 6th dynasty of the Old Kingdom (circa 2325

BC) to the beginnings of the Coptic period (4the9th centuries

AD), and a total of 438 individuals have been identified and

their pathologies studied. In the 2010 archaeological season a

total of 51 mummified bodies were recovered from the

UE.4013. Mummies were dated in the Late Period to Ptolemaic

Period (550e150 BC) based on the characteristics of the

mummification.

2. Case report

In the section B of the UE.4013, the individual W19 identified

as an adultmalewas recovered. The left hemi-face is lying in a

more superficial level and showed a fair degree of preserva-

tion (Fig.1a); by contrast, the deeper side was poorly pre-

served. This right side showed a postmortem fracture of the

parietal and the temporal bones. Preservative substances such

as bitumen mixed with linen were found inside the temporal

niversitari Sagrat Cor, c/ Viladomat, 288, 08029 Barcelona, Spain.r.com (A. Arboix).

Fig. 1 e a. Mummified head of the individual W19 “in situ” (arrow); b. Specular image of the brain vessels with the inner side

of temporal bone; c. Remains of preservative substances with the marks of two branches of the middle meningeal artery.

c o r t e x 6 3 ( 2 0 1 5 ) 2 1 7e2 1 9218

bone. The external surface of themass that contactedwith the

inner vault of the temporal bone, presented clear prints of

vascular vessels from the meninges. These structures “mir-

roring” the prints of the bone (Fig.1b), at this level, with all

likelihood, correspond to themiddlemeningeal artery with its

two branches, the anterior and the posterior (Fig.1c).

3. Discussion

Few cases of brain preservation have been reported in the

specialized literature. Only 10 cases were reported in a large

study from 2010 (Papageorgopoulou et al., 2010). Nonetheless,

in an exhaustive radiological (CT) study of 47 mummies from

the National Museum of Antiquities of Leiden, the

Netherlands (Raven & Taconis, 2005) brain remains were

detected in 8 cases and, moreover, in 16 cases cranial dura

were found in the CT images. In the past, the first one was

reported by D. S. Lamb in 1901 and, shortly thereafter, Sir

Grafton Elliot Smith (1902), presented information about nat-

ural mummified brains from El Amrah necropolis, near Aby-

dos in the Upper Egypt and dated in Middle Kingdom. In these

individuals, convolutions and brain sulci were preserved.

More than half century later, in the PUM III (Pennsylvania

University Museum Project) a multidisciplinary research team

demonstrated the presence of erythrocytes and leucocytes

adhering to the occipital region in an intracranial mass of a

2,200 year old female Egyptianmummy (Riddle, Ho,& Chason,

1975). Two years later, in the multidisciplinary project of the

Nakht mummy from the Royal Ontario Museum, the macro-

scopic study showed brain convolutions (Scott, Horne, Hart, &

Savage, 1977). Although in some natural mummified in-

dividuals the rate of brain preservation is quite good, little

evidences of meningeal coverings have been found (Doran

et al., 1986; Oakley, 1960; Tkocz, Bytzer, & Bierring, 1979).

In our case, following the extraction of the brain, em-

balmers filled it with preservative substances. As a result, no

brain tissue remains have been found, but instead prints of

vascular structures were preserved. It is a truly remarkable

finding and an interesting case because, to date, only anec-

dotic cases of covering structures have been reported in the

literature: a Korean mummy from the Joseon Dynasty

(1392e1910 AD) from Yongin site. This mummy showed re-

sidual vessels on the surface of the brain. (Kim et al., 2008).

Another case, a mummified left cerebral hemisphere of an 18

month old infant from Quimper, France dated from 13th

century had remains of pia mater with no vessel structures.

(Papageorgopoulou et al., 2010). The best preserved may the

case the lady of Mawangtui Tomb from the Han Dynasty (205

BC e 220 AD) with a high degree of preservation in the brain

with a dura mater, cerebellar tissue, the thalami and ven-

tricular system (Appenzeller & Aufderheide, 1999; Wei, 1973).

4. Concluding remarks

The most interesting question is how this structures, so

perishable under those post-mortem conditions have been

preserved. The conditions in this case must have been quite

extraordinary: we can speculate that something special

happened in individual W19 just at the moment of bitumen

insertion into the vault, unlike in the rest of the 62 brain re-

mains studied in the field. Assuming, as a work hypothesis,

that the physicochemical conditions of the bitumen-like

substance introduced into the skull of W19 individual, offer

c o r t e x 6 3 ( 2 0 1 5 ) 2 1 7e2 1 9 219

a possible means for prints of vascular structures, to harden

on cooling and lead to reveal exquisite anatomical details.

Acknowledgments

We thank Mª Angela Taul�e, Director of Museu Egipci of Bar-

celona and B�eatrice Huber site Director from Eberhard Karls

Universit€at.

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