Psychosurgery: A Historical Overview

Abstract

Neurosurgical treatment for psychiatric disorders has a long and controversial history. From the Stone Age use of trephining to release the demons of the spirit to the millimeter accuracy of stereotactic instruments currently used in the operating room, psychosurgery has enjoyed enthusiastic support as well as experiencing scorn. Today, psychosurgery is a minimally invasive and highly selective treatment that is performed for only a few patients with severe, treatment-refractory, affective, anxiety, or obsessive-compulsive disorders. Recent advances in technology and functional neuroanatomic techniques, as well as economic pressures to decrease the costs of caring for chronically ill patients, may provide an opportunity for psychosurgery to become a more attractive option for the treatment of psychiatric diseases. In this historical overview, the rise and fall of psychosurgery are described. A better understanding of the colorful history of this interesting topic should enable modern neurosurgeons and other health care professionals to meet the social, ethical, and technical challenges that are sure to lie ahead.

Tedaviye Dirençli Obsesif Kompulsif Bozuklukta Cerrahi Yaklaşımlar : Lökotomiden Gama Bıçağı Cerrahisine

“…Gama bıçağı uygulamasına bağlı olarak kısa dönem devam eden yan etkiler ödem ve buna bağlı olarak baş ağrısı, konfüzyon, inkontinans, daha uzun dönemde ortaya çıkan ve nadir görülen yan etkiler ise kilo kaybı, yorgunluk, hafıza kaybı, inkontinans, epileptik nöbet şeklinde bildirilmiştir 49 .…”

Deep Brain Stimulation for Psychiatric Disorders

“…In his subsequent publications describing these procedures, Moniz was the first to coin the term "psychosurgery." 1 Shortly thereafter, American neurologist Walter Freeman and a neurosurgical colleague, James Watts, started performing a similar procedure in 1936, which they renamed the "frontal lobotomy" later that year.…”

Psychosurgery, ethics, and media: a history of Walter Freeman and the lobotomy

“…8,35 Moniz, and his neurosurgeon colleague Almeida Lima, performed the first leucotomy on March 3, 1936, and reported a case series of 20 patients who underwent the procedure for severe distortions of mood. 8,12,25,35 Moniz reported that, following leucotomy, 35% of patients experienced complete relief of mental disturbance, 35% of patients benefitted from leucotomy but did not experience complete relief, and 30% of patients did not improve. 8,25 Aware of the revolutionary potential of this surgery, Freeman and Watts prepared to perform the procedure in the US.…”