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Psychosurgery.

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Humans↗

Psychosurgery.

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Humans↗

'Psychosurgery' in renaissance art.

Hieronymus Bosch and other early Renaissance artists depicted 'stone operations' in which stones were supposedly surgically removed from the head as a treatment for mental illness. These works have usually been interpreted either as portraying a contemporary practice of medical charlatans or as an allegory of human folly, rather than a real event. As trepanation for head injury and mental disease was actually carried out in Europe at this time, another interpretation of these works is that they are derived from a common medical practice of the day.

Engraving and Engravings↗

The role of psychosurgery in the treatment of selected cases of refractory schizophrenia: a reappraisal.

Prefrontal lobotomy (i.e. leukotomy) was widely performed for the treatment of schizophrenia during the late 1930s and 1940s but met with growing disrepute after the introduction of effective antipsychotic agents in the early 1950s. While non-invasive methods of treatment are undeniably preferable to somatic interventions for the management of psychiatric illnesses, there nevertheless continues to be a valid role for leukotomy in the treatment of patients with severe, chronic, refractory schizophrenia, particularly when the patient poses a risk to himself and/or to society. The present article traces the history of leukotomy in the treatment of schizophrenia, and reviews the author's experience with this surgical procedure in 16 patients who fulfilled the above criteria and underwent leukotomy during the years spanning 1985 1996. This operation reduced aggression and/or produced marked to slight improvement in all patients, and in no case led to adverse consequences. Thus, leukotomy is recommended as a legitimate treatment modality in selected patients with schizophrenia.

Adult↗

Leukotomy and aging in chronic schizophrenia: a followup study 40 years after psychosurgery.

Many followup studies have found that frontal leukotomy does not lead to marked changes in behavioral or cognitive functions in patients with chronic schizophrenia. However, these studies left open the issue of whether aging interacts with frontal lobe lesions in some way. This study examined 24 elderly schizophrenia patients who had experienced a bifrontal leukotomy and 48 subjects who were similar to the leukotomized patients in age, gender, chronicity, and overall severity of cognitive impairment. Clinical ratings of schizophrenic symptoms and cognitive deficits were obtained, as was a neuropsychological evaluation. Very few cognitive effects of leukotomy were noted, although clinically rated deficits in self-care were more severe in the leukotomized sample. These findings again suggest that the cognitive effects of frontal leukotomy procedures are limited and imply that aging does not interact substantially with leukotomy in patients with chronic schizophrenia.

Activities of Daily Living↗

Computed tomography after psychosurgery.

The computed tomography scans of patients who had frontal leukotomy show bilateral cysts in the frontal lobes that have attenuation values similar to cerebrospinal fluid, and are not contrast enhanced.

Adult↗