An ectocranial lesion on the Middle Pleistocene human cranium from Hulu Cave, Nanjing, China.

The earlier Middle Pleistocene human partial cranium from Hulu Cave, Tangshan, Nanjing (Hulu 1) exhibits an ectocranial lesion which covers most of the anterior neurocranium, largely between the temporal lines and extending from the supratoral sulcus to the anterior parietal bone. The endocranial surfaces and the remainder of the cranium (upper facial skeleton, lateral frontal bone, posterior parietal bones, and mid-occipital bone) are normal. The healed lesion exhibits both resorption and the laying down of new bone. Differential diagnosis suggests that the lesion was caused by either trauma (broad compressive trauma, tensile trauma to the scalp, or partial scalp removal) or burning (with damage to scalp and superficial neurocranium). Dietary deficiencies, infection, and neoplastic disorders do not fit the lesion characteristics. The Hulu 1 specimen therefore joins a growing sample of Pleistocene Homo remains with nonfatal and nontrivial disorders.