PREFRONTAL OPERATIONS FOR THE TREATMENT OF MENTAL ILLNESS

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Abstract
Prefrontal operations for the treatment of mental illnesses are described and the rationale and indications for doing such operations are briefly discussed Emphasis is placed on various types of leucotomy or lobotomy (severance of white matter) and on limited cortical ablation (gyrectomy or topectomy). Topectomy is less likely to result in lasting post-operative complications than a full scale prefrontal lobotomy as it sacrifices less cerebral tissue. Topectomy is usually more effective than transorbital lobotomy. The incidence of post-operative seizures is approx. 10% after lobotomy and about 16% after topectomy. However, in the author''s hands the operative mortality rate after topectomy in over 100 cases has been zero. About 20% of the cases operated upon by lobotomy or topectomy are markedly improved, another 20% considerably improved, the remainder showing little or no improvement.
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