Cranial surgical approaches in the 21st Century Identified Skeletal Collection

• Eight cases of skulls with lesions compatible with surgical procedures. • Comprehensive analysis: anthropological, neurosurgical, and imaging techniques. • Potential for identification in Forensic Anthropology casework. • Potential of imaging in anthropological interpretation. In Forensic Anthropology, identification is comparing information from a person whose fate and whereabouts are unknown with data from a person who is present but whose identity is unknown. The rarer and more distinctive the characteristics observed during the anthropological investigation, the greater the probability of reaching an identification. Taking this into account, cranial surgeries can be considered good individualization factors. The cases of skulls with lesions compatible with surgical procedures from the 21st Century Identified Skeletal Collection are presented, and their identification potential is discussed. This collection comprises 302 adult individuals, of which four females (aged 55 to 94 years) and four males (aged 67 to 92 years) present cranial lesions of surgical origin. The results of the macroscopic and imaging analyses (conventional x-rays and CTs) are presented, along with a detailed description and location of each lesion. In five cases there is clear evidence of bone remodelling. This research, which combines anthropological analysis with imaging and neurosurgical insights, demonstrates the importance of correctly interpreting these lesions, illustrating how important is a complete and interdisciplinary analysis for forensic expertise.