Treatment of Medically Intractable Mental Disease by Limited Frontal Leucotomy — Justifiable?

Publisher Website
Google Scholar
Abstract
During the past two decades intracranial surgery for intractable mental disease has evolved in the direction of greater precision in and the making of smaller lesions. The most experience has been with bilateral stereotactically produced lesions of a few milliliters' volume in the white matter related to the limbic system. These have been placed just above the anterior half of the corpus callosum in the fibers deep to the gyrus cinguli or in the fibers below the anterior horns of the lateral ventricles or in both areas. Such operations have nearly eliminated the sequelae of the earlier much more extensive lobotomies. Critical and thorough evaluations in Great Britain of relatively small numbers of patients operated on compared with retrospectively matched controls not operated on have revealed superior results in the leucotomized groups. The mental disorders most clearly responding to this surgery appear to be those characterized by stereotypy of an excessive and futile emotional response — i.e., phobias, anxieties, obsessions, depressions and the affective component (when present) of schizophrenia. (N Engl J Med 289:1117–1125, 1973)

This publication has 28 references indexed in Scilit: