The Insider editor Timur Olevsky says that the Havana syndrome is "Minor's syndrome," or
Superior canal dehiscence syndrome. It sounds like what the woman had in Tbilisi.
I think cranioplasty (or craniectomy) is very unlikely here;
(1) small size of incision (2) location (3) the patient looks far too well. Awake, little bruising or swelling. Staples indicate that the op. was done in approx. the past week or so, and she's got too much hair to have had post-trauma neurosurgery or cranioplasty IMHO.
I was wrong about this, in implying it was unlikely that the woman had had a craniotomy. Looked further into the subject; the incision shown
is consistent with a small craniotomy to treat superior canal dehiscence syndrome (SCDS). The minimal pre-op shaving is also unproblematic.
Looks like things learned in one context might be different in another...
On realising my errors, like any other Metabunker I smiled to myself, happy that I could put the record straight
@Agent K's observation that SCDS resembles the symptoms of the US woman in Tbilisi is supported by the photos, which may be of someone who has had surgical SCDS repair via a small middle fossa craniotomy.
The claim that the patient had two metal plates inserted into her skull remains sensationalist; the surgeon may have used already-mentioned max-fax mini-plates to fix the returned bone but not a plate to replace part of the skull.
Actually I had real trouble visualising the approach used in SCDS repair, these illustrations helped:
1st illustration from
"Superior semicircular canal dehiscence syndrome", W.L. Bi, R. Brewster, D. Poe et al. 2017,
Journal of Neurosurgery 127 (6). Abstract only viewable without payment at this link,
https://thejns.org/view/journals/j-neurosurg/127/6/article-p1268.xml.
Other illustrations from Stanford Medicine (Stanford University)
Otological Surgery Atlas, Illustrations copyright of Dr. Jackler and Ms. Christine Gralapp,
https://otosurgeryatlas.stanford.ed...rgery/superior-semicircular-canal-dehiscence/;
some editing and added labels/ notes by me.
Pics 1 and 2, normal anatomy.
It might be that the woman in Tbilisi was affected by SCDS (also sometimes called Minor's syndrome, but there was another Minor's syndrome beforehand to do with spinal cord injury, so that term is potentially confusing).
SCDS is caused by a malformation of the temporal bone floor which exposes the upper arch of the superior semicircular canal, not initially by a problem with the semicircular canal itself (although the exposed upper surface of its arch may develop a fistula).
It's hard to conceive, realistically, of any ranged weapon method of any sort that could
selectively erode the upper surface of the floor of the temporal bone, but not affect the tiny delicate structures of the middle and inner ear, or the outer surface of the temporal bone (at the sides of the head), the eardrum or the bone surrounding the auditory canal.
Nor does this hypothetical weapon seem to cause bleeding in the brain (shows up well on CT), damage to the dura mater surrounding the brain or visible damage to the surface of the temporal lobe (this would be noticed during surgery for SCDS repair) :
External Quote:
The classic MCF approach allows for a top-down repair of a defect; however, it is criticized for extent of temporal lobe retraction
-i.e. the temporal lobe is seen and moved during the procedure;
"Outcomes after Mini-Craniotomy Middle Fossa Approach Combined with Mastoidectomy for Lateral Skull Base Defects",
Walia, A., Lander, D., Durakovic, N., Shew, M., Wick, C.C., Herzog, J.,
American Journal of Otolaryngology 2021 Jan-Feb; 42(1)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8048087/ (also mentions the dura mater IIRC).
I guess several convergent particle beams could
theoretically do this for a perfectly still target if the operator already had head CT/ MRI scans of the target. It would be a huge surgical breakthrough!
However, the "targeted" bone, whether vaporised, liquified or fragmented would have to go
somewhere.
The aetiology of SCDS is disputed; Minor himself believes it is primarily congenital (or at least the underlying cause is, a thin area of temporal bone floor):
External Quote:
Based on the results of a large temporal bone study at Johns Hopkins, we believe SCDS is primarily a congenital phenomenon.
"Superior Canal Dehiscence Syndrome: Lessons from the First 20 Years", Bryan K. Ward, John P. Carey, Lloyd B. Minor,
Frontiers in Neurology 2017, 8 (177)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408023/#B2
The authors continue,
External Quote:
In as many as one quarter of cases, however, another inciting injury such as a traumatic head injury or Valsalva initiates symptoms
...they accept that predisposed people who are asymptomatic but already have a thin area of temporal lobe floor over the superior semicircular canal arch might have that thin area damaged by external factors (or a rapid increase in pressure within the head).
Peng, Ahmed et al. (2014) support this, finding SCDS in two patients who have sustained temporal bone fractures
"Temporal bone fracture causing superior semicircular canal dehiscence", Kevin A Peng, K.A., Ahmed, S., Yang I., Gopen, Q.,
Case Reports in Otolaryngology, 10 September 2014
https://pubmed.ncbi.nlm.nih.gov/25295207/,
although the mechanism is different: Fractures that extended through "normal" temporal bone over the semicircular canal.
Karen F Watters, John J Rosowski, Todd Sauter, Daniel J Lee (2006) describe
"Superior semicircular canal dehiscence presenting as postpartum vertigo" in
Otology & Neurotology, 27 (6).
https://pubmed.ncbi.nlm.nih.gov/16936563/
With the exception of the two Peng, Ahmed et al. (2014) patients with their traumatic, extended fractures, it seems that SCDS affects people who have an underlying susceptibility. In a minority of cases symptoms come on rapidly after an identified precipitating event (traumatic head injury, receiving the Valsalva manoeuvre, childbirth) but all those patients have an unusually thin layer of bone over the superior canal beforehand.
Although one of the symptoms of SCDS is hearing loud noises, I haven't found any evidence that it is
caused by loud noises.
This underlying predisposition to SCDS may be much more common than the rare diagnosis of SCDS suggests,
External Quote:
According to current research, in approximately 2.5% of the general population the bones of the head develop to only 60–70% of their normal thickness in the months following birth. This genetic predisposition may explain why the section of temporal bone separating the superior semicircular canal from the
cranial cavity, normally 0.8 mm thick, shows a thickness of only 0.5 mm, making it more fragile and susceptible to damage through physical head trauma or from slow erosion. An explanation for this erosion of the bone has not yet been found.
Wikipedia, Superior canal dehiscence syndrome
https://en.wikipedia.org/wiki/Superior_canal_dehiscence_syndrome
[Ward, Carey and Minor (ibid). believe genetic factors are a possibility, but are more confident in stating that the condition is congenital regardless of causation.]
It must be possible that the Tbilisi "victim" has suffered SCDS, and has associated its rapid onset with concerns surrounding "Havana Syndrome".
On balance, it must be extremely unlikely that anyone has developed a weapon that can induce SCDS in someone without a predisposition. The weapon would have to be capable of "stealing" a
specific layer of bone, which vanishes without trace, from
inside the skull, after the beam (or whatever) has travelled through skin, muscle and the temporal bone at the side of the skull, again without leaving any traces or injury, and apparently without damaging any other structures
at all (excepting possibly the upper arch of the superior semicircular canal).
In people with a pre-existing temporal bone floor weakness, it seems a variety of physical stressors (childbirth, Valsalva, head trauma) can cause SCDS; more often the appearance of symptoms seems unrelated to memorable health / life events.
I'm not sure it makes sense to develop, and illegally use, a weapon that
might injure 2.5% of possible targets when their susceptibility isn't known, even if such a weapon is possible.
Why risk a dependable FSB asset, and perhaps unmask experimental weapons technology, in an attempt to hurt the wife of a member of embassy staff, when she has a 97.5% chance of being invulnerable?
So while the Tbilisi woman might have had sudden-onset SCDS, I doubt very much that this was deliberately caused, or is part of "Havana Syndrome".