Evidence of pathological conditions in the Florisbad cranium

Palaeopathological studies of the middle Pleistocene cranium from Florisbad (Free State, South Africa) document the presence of extensive cortical lesions and areas of thinning, a widened medullary cavity with destruction of the diploë, orbital roof lesions, a benign ectocranial neoplasm, and evidence for alveolar destruction, resorption, and antemortem tooth loss. Differential diagnosis suggests one or more possible aetiologies, including a haematological disorder, metabolic condition(s), Paget’s disease of bone, or non-specific infection perhaps following trauma. Moreover, if not directly associated with those on the external vault, orbital lesions alone could have been caused by infection or an indeterminable factor such as pressure from an enlarged organ. Multiple parasagittal lesions on the internal vault cortex probably represent expansile lesions left by enlarged arachnoid granulations. A multifactorial model of pathogenesis may be most appropriate to account for dentoalveolar lesions and antemortem tooth loss. Additionally, there are clear indications of diagenetic alteration deep within the vault, as well as multiple signs of degeneration on the cranium. These complicate the assessment of pathological alterations and identification of their possible aetiology. The Florisbad cranium is the latest specimen to join the growing sample of Pleistocene hominin remains with non-fatal and non-trivial pathological disorders adding to understanding of early human ecology and lifestyle.