 Everyone, I'm very delighted to be here. I want to thank folks for coming to the presentation on Saturday afternoon. I want to really thank the organizers for what has been a really engaging and interesting session for inviting us to be here. And I also want to thank the YouTubers who might listen to us one day if we end up online. And I would like to give this presentation on the behalf of my colleagues, one of whom is going to come really into play, who's an assistant professor of neurology, the University of Kentucky Medical School in the United States, as well as my Hungarian-Germanian collaborators. And this presentation today is really hopefully going to get us thinking about a fairly common kind of bioarchaeological data. And that is the reality of anti-mortem cranial trauma that we see, that oftentimes gets interpreted in the context of thinking about interpersonal violence, that maybe gets discussed when we think about the conflicts that people engaged in, sometimes practices about weaponry, sometimes even sex-specific or gender-violent practices. And so this is something that is fairly common. However, an area that's probably and woefully understudied when it relates to anti-mortem cranial trauma in bioarchaeological context is that soft tissue interaction related to the reality of traumatic brain injuries. And what I want to do today is get us thinking about the way in which bioarchaeologists might be able to think about traumatic brain injuries when we look outside of our discipline. Because there's a lot there when we think about what psychologists, neurologists, and people who deal with clinical context of traumatic brain injuries. And these are just two screenshots of some review papers that sort of drive home what I hope is the thesis of my argument that traumatic brain injuries are a disease process and not a static event, and that they're ultimately longitudinal in their manifestation. So that even though when we see the dry bone lesion of a healed cranial injury, what we're really looking at is something longitudinal that has potentially effects from a short-term consequence to a prolonged consequence and sometimes even a permanent consequence. And that's something very important that I think bioarchaeologists can consider. We also realize that digging into some bioarchaeological data, for example, Jesper Bolton's group in Denmark have actually shown this when they've looked at medieval people who had cranial injuries and who did not have cranial injuries. And that they've seen, for instance, that individuals with depressed cranial fractures that are healed have earlier onset mortality. And this is something that is mirrored in the clinical literature depending on the studies and there's a lot of them where your likelihood of earlier mortality is virtually guaranteed if you experience a traumatic brain injury at some point in your life, as well as a host of other kinds of complications. What's also interesting about this reality, about thinking about traumatic brain injuries are historic accounts and I have on the slide here pictures of two Americans who were both well-known to have sustained traumatic brain injuries at different points in their life. On the left is the American abolitionist Harriet Tubman who during her early years as an enslaved person was injured by her overseer which led to a lifetime of narcoleptic episodes and headaches that are well reported. And even though she lived to old age, which is slightly uncommon for the period and for people with traumatic brain injuries, this was something that stayed with her for entire life. On the right hand side is the well-known case of Phineas Gage who was the American railroad worker who suffered an accident where the spike that he's holding in his right hand actually was launched through his skull and was the first time that physicians realized that a brain injury might permanently alter a person's personality so that it was the first time people realized that maybe if you injure your frontal lobe this is what a consequence might be. If you injure a parietal lobe this is what might be a consequence so on and so forth. So with this background in mind I want to take us through one example in the bioarchaeological literature that is really recent from 2018 that sort of couples this question about interpreting brain injuries as they've been mapped on to cranial defects. And so this is a paper that looks at a case study from Neolithic Sweden with an individual man who had suffered an anti-mortem injury to his parietal bone I use this pointer and I'm staring at it all day. And the paper goes into what the consequences of injury that part of the brain might have involved and the paper very eloquently then describes through the lens of the bioarchaeology of care what might have been the manifestations of how a person might have sustained help or care in both the acute period right after the injury and over the long term. So with this background we'll go into what has been the last seven years of my field work focusing on the historic and medieval region of Transylvania. This is really why I wanted the pointer. So we're looking at this region here which of course for the majority of its history was part of the Kingdom of Hungary. This border of Hungary of course existed for about a thousand years and it didn't really change until the end of World War I. And within this particular region of the Kingdom of Hungary we imagine what we know now as the modern borders of Hungary which were changed after the war where we're going to be next year for EAA and Budapest but I also want to draw people's attention to a region in the far eastern reaches of the Carpathian Basin where an ethnic group of Hungarians called the Sike have lived and lived today numbering somewhere between 550 to 600,000 people. So this region is where my work has been centered that if you were to go there today you're going to be right in the middle of Remain. And so one of the co-authors of this presentation is an archaeologist based at a museum depending what language you speak and the city of Oterpliusek we ask if you're a Romanian speaker or the city of Sike-Udvarhe if you are Hungarian speakers. And on this map you can see these yellow dots which is where Zolt and his team have conducted large numbers of salvage excavations usually around medieval-era churches in one village or another related to different kinds of mitigating flood events, erosional events or in some instances historic preservation as is the case in the Romanian village of Mugeni or if we call it by its Hungarian name the village of Bogos. And so in this community of Bogos is a beautiful if you ever have the opportunity to go into Transylvania I recommend stopping by this beautiful church that had probably its origin in the 12th century that for several years was the subject of a really wide-scale renovation and in the churchyard there was a drainage ditch that was installed you can sort of see where that is and you can see on the map where the trench is on the outside of the church within that trench 191 burials were recovered and were part of what myself and my field school students analyzed over a two-year period a couple of years in this context is the subject of today's case study who was grave 195 who is a middle adult now whose radiocarbon date puts in somewhere between 1450 to 1640 so a late medieval or perhaps early moderner depending on how we define the medieval period in Transylvania we might still be able to fudge it and say he's a late medieval man his skeleton is not complete the preservation is fair to moderate but what was preserved is a really remarkable healed defect on his left parietal bone which you can see in the image that has well-healed margins it also is represented by having a radiated fracture and is luckily intact if the technology works I'm going to show you I've got a three-dimensional scan that we'll take a look just to see what this cranium looks like in the posterior region you're going to see some taphenomic alterations in the form of coffinware but as the skull rotates around you're going to be able to see the margins of that defect as well as the radiating fracture in a bit more detail I haven't included any endocrinial shots but what's interesting is we can see some of the healing right around the margins of the defect but what we don't see is the radiating fracture puncturing the endocrinial table regardless it's interesting to think about the anatomical location of this above what in forensic anthropology we call the hat brim line it's interesting that it's on the left hand side and another talk discussed what I think happened as the etiology of this injury but suffice it to say this man suffered a significant penetrating defect to the cranium which is where my colleague who is a neuropsychologist comes into play and when I talked to him about this case he said how come bioarchaeologists aren't really investigating these kinds of questions like Tim because we don't know neurologists like you he said well let me help and he said first of all if you injure your skull in this region you will have injured your left parietal row and he said there's manifestations of things that can occur that again could be a short term impairment could be prolonged could be permanent one of those are impairing to some degree your tasks of working memory so that might be for example today if someone tells you their phone number and you write it down if you have this region of your parietal lobe damaged you might not be able to recall what it is or you might be able to say let's go to restaurant X after the meeting or this pub not being able to retain that information that you were given immediately and again that could be a permanent fixture of this person's memory if you're injured on your left parietal lobe because of the way in which sort of the brain functions the sense, sight, taste functions on the right side of the face might have been impaired so that might have meant if there was something hot or cold he would not have known would not have been able to sense that and could have had some kind of degree of paralysis of this side of the sensory portions of the face there could have also been a serious inability to comprehend speech so people in his household in his community might have been having conversations to which he no longer knew the meaning of simple words whether those were things related to food stuffs bodily hygiene family members whatever people were saying he might not have had the same ability to understand what he was told prior to this injury and then lastly is that there could have been some disruption of visual tasks and we know that of course the occipital lobes are where our vision senses are but in that parietal lobe are where the important fibers are that transmit some of those signals and so it's known in the clinical literature that sometimes people with a parietal lobe injury have some cortical blindness as a result of that of that defect so to bring this back to this individual I think it's quite useful as we move forward for this as we think about this in other instances to not exclude a traumatic brain injury from his osteobiography when we think about also through the very eloquent extension of the bioarchaeology of care for instance there is virtually no way after sustaining an injury like that that he would not have been made unconscious for some amount of time and so what kind of care does a person need who is made to be unconscious for how long as your cranium is healing up that has an open wound what kind of care is required in that instance and then lastly over the period of time that the injury healed what are the manifestations of how if there was some kind of prolonged or permitted damage how might of people in his household worked with him how might of they worked with him at his frustrations for not being able to recall words that he knew or words that he might have thought that he might have should have known so on and so forth so I think that this is going to be a case study as my colleagues and I continue to think through it that the clinical literature that is really clear on the experiences of people with parietal lobe injuries as well as any other kind of study where you might see a cranial injury I think that those are going to be really important data sets to draw from as we continue to think about, re-examine and maybe improve upon how we have dealt with our interpretation of anti-mortem cranial injuries so I want to thank you for your attention and take any questions if there's any time maybe there's not yeah, oh great, thank you