{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T14:04:46Z","timestamp":1791209086278,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2002,6,13]],"date-time":"2002-06-13T00:00:00Z","timestamp":1023926400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Phys Anthropol"],"published-print":{"date-parts":[[2002,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This paper describes a phenomenon in the endocranial plate, which we have termed \u201cserpens endocrania symmetrica\u201d (SES), and discusses its value as a diagnostic tool. The affected discolored bone area exhibits disruption of the endocranial surface, lending it a maze\u2010like appearance. Histological sections demonstrate that the process is limited to the most superficial portion of the endocranium, with no diploic and ectocranial involvement (sinus areas excepted). Adult skulls (n = 1,884) from the Hamann\u2010Todd collection (HTH), housed at the Cleveland Museum of Natural History, were utilized for the present study. SES was recognized in 32 of the 1,884 skulls studied (1.7%). The frequency of SES among individuals reported to have died from tuberculosis (TB) was 4.4%. The rate of SES in the non\u2010TB sample was only 0.53%. The locations were as follows: limited to sinus area, 28.1%; calvarium (excluding the sinuses), 46.9%; sinus + calvarium, 25.0%. SES was bilateral in 90.9% of cases. Twenty\u2010five of the 32 individuals (78.1%) with SES in the HTH collection had tuberculosis specifically listed as the cause of death. Six of the other 7 individuals had infections other than TB. In 29 of the 32 individuals with SES, infection involved structures within the thorax. As SES was also associated with another osteological phenomenon known to represent pulmonary disease, i.e., hypertrophic osteoarthropathy (HOA; 68.0% of SES individuals also had HOA), SES may be of diagnostic value in paleopathology for the recognition of intrathoracic disease, and perhaps tuberculosis. Am J Phys Anthropol 118:201\u2013216, 2002. \u00a9 2002 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ajpa.10077","type":"journal-article","created":{"date-parts":[[2002,10,6]],"date-time":"2002-10-06T12:38:48Z","timestamp":1033907928000},"page":"201-216","source":"Crossref","is-referenced-by-count":99,"title":["Serpens endocrania symmetrica (SES): A new term and a possible clue for identifying intrathoracic disease in skeletal populations"],"prefix":"10.1002","volume":"118","author":[{"given":"Israel","family":"Hershkovitz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles M.","family":"Greenwald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Latimer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyman M.","family":"Jellema","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Wish\u2010Baratz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vered","family":"Eshed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Dutour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce M.","family":"Rothschild","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2002,6,13]]},"reference":[{"key":"e_1_2_1_2_1","volume-title":"The Cambridge encyclopedia of human paleopathology","author":"Aufderheide AC","year":"1998"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-5876(98)00024-X"},{"key":"e_1_2_1_4_1","unstructured":"CobbWM.1932.Human archives. Ph.D. thesis Western Reserve University Cleveland Ohio."},{"key":"e_1_2_1_5_1","first-page":"140","article-title":"Serpens endocrania symmetrica (SES): a new term and possible sign of cranial tuberculosis","volume":"28","author":"Greenwald C","year":"1999","journal-title":"Am J Phys Anthropol"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1961.03040490003002"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00335317"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00214011"},{"key":"e_1_2_1_9_1","first-page":"201","article-title":"The clinical significance of the spiralling of arterial blood vessels","volume":"67","author":"Langen CD","year":"1964","journal-title":"Proc Kong Ned Akad W Biol"},{"key":"e_1_2_1_10_1","first-page":"2632","article-title":"Classical diseases whose \u201cdisappearance\u201d makes diagnosis difficult: tuberculosis and poliomyelitis","volume":"1","author":"Leech RW","year":"1974","journal-title":"Northwest Med J"},{"key":"e_1_2_1_11_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.198.4314.291"},{"key":"e_1_2_1_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/01459740.1978.9986939"},{"key":"e_1_2_1_13_1","volume-title":"Clinical significance of the blood in tuberculosis","author":"Muller GL","year":"1943"},{"key":"e_1_2_1_14_1","series-title":"Radiology of the skull and brain: anatomy and pathology","author":"Newton TH","year":"1977"},{"key":"e_1_2_1_15_1","volume-title":"Identification of pathological conditions in human skeletal remains","author":"Ortner DJ","year":"1981"},{"key":"e_1_2_1_16_1","volume-title":"Diagnosis of bone and joint disorders","author":"Resnick D","year":"1988"},{"key":"e_1_2_1_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02116853"},{"key":"e_1_2_1_18_1","volume-title":"Paleopathology: disease in the fossil record","author":"Rothschild BM","year":"1993"},{"key":"e_1_2_1_19_1","first-page":"2221","article-title":"Recognition of hypertrophic osteoarthropathy in skeletal remains","volume":"25","author":"Rothschild BM","year":"1998","journal-title":"J Rheumatol"},{"key":"e_1_2_1_20_1","first-page":"83","volume-title":"Gedenkschrift f\u00fcr J\u00fcrgen Driehaus","author":"Schultz M","year":"1990"},{"key":"e_1_2_1_21_1","first-page":"1","volume-title":"Anthropologische Beitr\u00e4ge 4A and 4B","author":"Schultz M","year":"1993"},{"key":"e_1_2_1_22_1","first-page":"201","volume-title":"Forensic taphonomy\u2014the postmortem fate of human remains","author":"Schultz M","year":"1997"},{"key":"e_1_2_1_23_1","volume-title":"Nonparametric statistics for the behavioral sciences","author":"Siegel S","year":"1956"},{"key":"e_1_2_1_24_1","volume-title":"Paleopathological diagnosis and interpretation","author":"Steinbock RT","year":"1976"},{"key":"e_1_2_1_25_1","volume-title":"Bone and bones. 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