Did Subdural Hematoma Kill Thomas Aquinas?

LOS ANGELES — Almost 750 years in the past, a mysterious sickness felled Italian theologian Thomas Aquinas earlier than he reached his sixth decade. Now, a workforce of medical college students and a neurosurgeon assume they’ve recognized his killer: persistent subdural hematoma.

The researchers got here to their conclusion after analyzing reviews of the Catholic saint’s closing days and inspecting a cranium at an Italian abbey which will — or might not — be his.

“Finally, this can be a traditional persistent subdural hematoma story,” stated College of Kansas Medical Heart medical scholar Gabriel J. LeBeau, who introduced the findings April 22 right here on the American Affiliation of Neurological Surgeons (AANS) 2023 Annual Assembly.

In the event that they’re proper, the researchers have pinpointed the reason for demise of probably the most influential individuals who ever lived, a Dominican friar who wrote tens of millions of phrases within the thirteenth century and continues to be revered at present as a thinker, reformer of Christian thought, and man of religion.

In a precursor to the ideological battles of the twenty first century, Aquinas sought to reconcile science and faith. One in every of his core beliefs was that “cause and religion are eminently appropriate, as a result of God can’t be the supply of a contradiction or of error,” in keeping with the 2022 e-book The New Cambridge Companion to Aquinas .

Aquinas died on March 7, 1274, on the age of about 48, in an abbey midway between Rome and Naples. In line with historic accounts gathered by the analysis workforce, about 5 weeks earlier he’d hit his head on the department of a tree fallen sideways whereas touring from Naples to the Second Council of Lyon, a gathering of Catholic leaders in a French city.

Aquinas was “shocked” and fell to the bottom, the accounts say, and he stayed close by for 4 or 5 days. Whereas he was weak and misplaced his urge for food, he was nonetheless lucid, and had no fever and no focal neurological deficits. He was moved to the Abbey of Fossanova, the place he stayed for a month. There, his situation worsened — signs included weak spot, lack of urge for food on account of nausea, and somnolence. Then he died.

There are a number of theories about what killed Aquinas. In line with LeBeau, the Italian poet Dante accused a monarch named Charles of Anjou of poisoning him to cease him from changing into cardinal or pope. However there isn’t any proof to help this concept, LeBeau instructed Medscape Medical Information.

In fashionable instances, a 2017 report in The Lancet Neurology steered that Aquinas had strokes or transient ischemic assaults previous to his encounter with the tree department. They brought on his mind to shrink, the report speculates, and worsened the consequences when the tree department brought on an epidural hematoma.

For the brand new report, LeBeau and colleagues examined accounts of the saint’s sickness and visited a partial cranium that is reputed to be his on the Abbey of Fossanova.

“The mandible is lacking, and huge parts of the occipital bone, parietal bone, and far of the cranium base are lacking,” LeBeau stated. “Nonetheless, the zygomatic bone, the facial bones, and the frontal bone had been largely intact.”

The proof satisfied the workforce that Aquinas died of a persistent subdural hematoma that was attributable to the sooner head injury.

“There was a minor trauma adopted by a interval of lucidity and relative normalcy, then gradual decline,” LeBeau stated, which inserts the idea of a rising hematoma. And Aquinas had “traditional signs,” he stated, together with generalized weak spot, lack of potential to talk or perceive language, nausea, lack of urge for food, and sleepiness.

It is not clear if he suffered a concussion initially, LeBeau stated, though it is doable.

Power subdural hematomas develop slowly over time and might each compress the mind and trigger it to swell, Mayo Clinic neurosurgeon Teodoro Forcht Dagi, MD, MPH, instructed Medscape Medical Information.

Dagi, who research medical historical past, stated the hematoma prognosis is smart. There isn’t any proof of a skull fracture, he stated, and a stroke appears additionally unlikely. It could have occurred abruptly — therefore the title “stroke,” which refers back to the situation’s suddenness — and instantly affected the saint’s well being, he stated.  

What if Aquinas lived in fashionable instances and suffered from persistent subdural hematoma now? If there weren’t complicating elements, Dagi stated, “we might have been capable of picture it, we might have operated on it, and he would have survived.”

Whereas the idea concerning the saint’s demise is “a robust scientific prognosis,” LeBeau stated that extra proof is required. The researchers, he stated, hope to make use of noninvasive x-ray fluorescence spectrometry to look at the cranium in Italy and one other cranium in Toulouse, France, additionally believed to belong to Aquinas.

American Affiliation of Neurological Surgeons (AANS) 2023 Annual Assembly. Introduced April 22, 2023.

No research funding is reported. The authors and Dagi have disclosed no related monetary relationships. 

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