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Saturday, July 23, 2022

A Possible Stroke Victim from Pharaonic Egypt - ScienceDirect

https://www.sciencedirect.com/science/article/abs/pii/S1878875022009081

A Possible Stroke Victim from Pharaonic Egypt

Miguel A.Sánchez2 SalimaIkram3
1
University of Alcalá Department of Life Sciences, Faculty of Sciences University Campus, Crta. Madrid-Barcelona, Madrid, Spain
2
Englewood Health, Englewood, NJ, and ICAHN Mount Sinai School of Medicine, New York, NY, USA
3
The American University in Cairo, Department of Sociology, Egyptology and Anthropology, New Cairo, Egypt

Received 30 April 2022, Accepted 23 June 2022, Available online 30 June 2022.

https://doi.org/10.1016/j.wneu.2022.06.123Get rights and content

Objective

We describe the consequences of a stroke in an adult mummy from ancient Egypt including the differential diagnosis. To our knowledge this is the oldest hemiparalysis to be published in the scientific literature.

Methods

The mummy, from the 25th Dynasty (c. 747−656 b.c.), was found during excavation of the tomb chapel of Hery (TT 12) and Baqi, of the early 18th Dynasty (c. 1550−1292 b.c.). Seventeen mummified bodies were found in a small corridor connecting the 2 tombs. The mummy labeled Individual 6833 was studied macroscopically and radiologically and was unique in its positioning, the presence of a crutch, and the use of sticks as supports.

Results

The body belonged to a woman, between 25 and 40 years of age. The type of mummification was of a high level, with excerebration and evisceration carefully performed.

Conclusions

The woman suffered a stroke late in life, with left hemiparalysis after bone growth was completed, and she lived with the results for several years.

Introduction

Strokes occur when blood supply is disrupted, resulting in necrosis of brain parenchyma. They represent the second cause of mortality in patients older than 60 years old and are a main cause of disability.1 Indubitably strokes have occurred historically. The first conclusive anatomically proven diagnosis of a stroke was reported in 2017 in the body of an 18th century 73-year-old Italian priest,2 Don Giovanni Arcangeli (1677/78−1751). In their macroscopic examination, the authors described "an eye-catching unilateral gryposis of the left hand, absent in the contralateral limb. … Additionally, the left hand seems to show a rather striking degree of contracture of the tendons of the dorsum of the hand." Furthermore, the Church's documentary sources state that "the Reverend don Giovanni Arcangeli, as a result of his poor health caused by an apoplectic illness … ."

We have identified one of the, if not the, earliest examples of a stroke in an Egyptian mummy, tentatively dated to Egypt's 25th Dynasty (c. 747−656 b.c.) and the focus of this report. This is the twilight of Egyptian history, when Egypt was ruled by Nubian pharaohs who had appropriated pharaonic religion and customs.

Section snippets

Material and Methods

The Spanish Archaeological Mission to Dra Abu el-Naga (Proyecto Djehuty) has been working on the west bank of the Nile at Luxor (Egypt) since 2002. Excavations revealed dozens of well-preserved mummies including Individual 6833, missing only the feet. This mummy was studied macroscopically and radiographically on site with portable radiographs using the 9020 HF Clarox Equino, of 1.35 kW, 90 kV, and 15 mA. Due to Egyptian law, it was impossible to remove the mummy from the site for computed

Results

Radiography identified the body as female, based on pelvic features,4 between 25 and 40 years of age.

The individual was positioned straight, with the legs together. The right arm is stretched alongside the body with the palm facing the femoral trochanter. The left arm was flexed in the elbow with the forearm over the chest and the left hand hyperflexed. The head was facing down, with contracted shoulders. Although the head of children's mummies are often thus positioned5 (and personal

Discussion

The position of the shoulders, head, flexed arm, and, to a lesser extent, the probable inward turning of the left foot suggests that the woman was suffering from a right brain insult.

The typical pattern of neuromusculoskeletal involvement in individuals affected is characterized by 1) painful shoulder in adduction and internal rotation (due to a scapulohumeral subluxation, causing an abnormal position of the head); 2) elbow flexed, forearm in pronation, wrist in flexion and claw fingers

Conclusions

The radiologic examination of this female mummy, aged 25−40 years, who died about 2700 years ago, reveals an abnormal position of her body, with indications that she suffered a right cerebral stroke with the expected left hemiplegia. During the mummification process an attempt was made to correct the position of her head and chest by including 2 sticks at her back, giving her an erect posture for eternity. A stick or a crutch was also provided for her, most likely the one she used in life. The

CRediT authorship contribution statement

Jesús Herrerín: Conceptualization, Formal analysis, Investigation, Methodology, Supervision, Visualization, Writing – original draft, Writing – review & editing. Miguel A. Sánchez: Formal analysis, Investigation, Methodology, Writing – original draft, Writing – review & editing. Salima Ikram: Formal analysis, Investigation, Methodology, Writing – original draft, Writing – review & editing.

Acknowledgments

This article is part of the research project HAR2017-88671-R, situated within the Spanish National Program for Scientific Research, Technology, and Innovation. We are grateful to José M. Galan, director of the Proyecto Djehuty, for his support and encouragement, and Francisco Bosch-Puche for his archeologic expertise.

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