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Later studies documented cases identified from a range of sites in Oaxaca and central Mexico, such as Tilantongo, Oaxaca and the major Zapotec site of Monte Albán.

Two specimens from the Tlatilco civilization's homelands (which flourished around 1400 BC) indicate the practice has a lengthy tradition.

It is often used to relieve pressure beneath a surface.

A trephine is an instrument used for cutting out a round piece of skull bone.

Trepanation is a treatment used for epidural and subdural hematomas, and for surgical access for certain other neurosurgical procedures, such as intracranial pressure monitoring.

Even so, some evidence of genuine trepanation in Mesoamerica (i.e., where the subject was living) has survived.

The earliest archaeological survey published of trepanated crania was a late 19th-century study of several specimens recovered from the Tarahumara mountains by the Norwegian ethnographer Carl Lumholtz.

In the graveyards of pre-Christian (Pagan) Magyars, archeologists found a surprisingly high frequency (12.5%) of skulls with trepanation, although more than 90% only partial (these served probably ritual purposes).

The trepanation was performed on adults only, with similar frequencies for males and females, but increasing frequency with age and wealth.

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