Hydrocephaly at Medici court of 16th century Florence

Introduction. Hydrocephalus is a congenital or acquired pathology of CNS caused by a misbalance between the production of cerebrospinal fluid and its absorption. Within the framework of the “Medici” Project, the ancient rulers of Renaissance Florence, a paleopathological team of experts from the University of Pisa, the University of Florence and the Superintendence for Florentine Museums, is carrying out a study on 49 tombs of some of the Medici family members (16th-18th centuries) housed in the so-called Medici Chapels of the Basilica of San Lorenzo in Florence. The most recent biomedical technologies have been employed to obtain as much information as possible about the genetic make-up, eating habits, life styles and diseases of these important rulers of Renaissance Florence. Methods. The skeletal remains of a child, recovered inside a small crypt of the Basilica of S. Lorenzo revealed a little boy of about 5 years, with a stature of 1.15 m. This individual has been identified whit Don Filippino (1577-1582), young son of the Grand Duke Francesco I (1541-1587). The abnormally enlarged skull of this subject was submitted to macroscopic and radiological study (standard X-ray and CAT). Results and discussion. The paleopathological study, cranial dimensions and calculation of cranial capacity show evident hydrocephaly. The curvature of the left tibia and fibula demonstrates light rickets. A portrait of don Filippino, painted in the same year of death (1582), shows a picture of non-severe hydrocephaly, with low implant of the orbits and auricles and evident expansion of the cranial vault. Conclusion. This case of hydrocephaly is important not only from paleopathological point of view, but also because it is the first time that a diagnosis of this disease is supported also by an artistic representation.