Psychosurgery - History, Contemporary Psychosurgery, Patient Selection, Postoperative Care, Current Status
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Psychosurgery is the alteration or destruction of brain matter in order to alleviate severe, long-lasting, and harmful psychiatric symptoms that do not respond to psychotherapy, behavioral, physical, or drug treatments. Psychosurgery involves opening up the skull or entering the brain through natural fissures such as the eye sockets, and injecting various tissue-altering solutions, removing or destroying brain tissue using various tools, or severing certain connections between different parts of the brain. Techniques used in this controversial and now rarely performed surgical procedure have changed greatly since its beginning in the 1930s.
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The first report of surgery on the brain to relieve psychiatric symptoms has been traced to the director of a mental asylum in Switzerland, Gottlieb Burckhardt, who in 1890 removed parts of the cerebral cortex. He performed this procedure on six patients described as highly excitable. The procedure, however, did not seem to lessen the patients' degree of excitability, and in fact seemed to …
Over time, psychosurgical procedures have been created that are more precise and restricted in terms of the amount of brain tissue affected. During the 1950s, a stereotaxic instrument was developed that held the patient's head in a stable position and allowed the more precise manipulation of brain tissue by providing a set of three-dimensional coordinates. Stereotaxic instruments generally …
Psychosurgery has gone through periods of widespread, relatively uncritical acceptance, and periods of great disfavor in the medical community. In the early years of its use there were no well-conducted, detailed, rigorous studies of outcome or differences in procedure. The development of various diagnostic and psychological assessment measures has enabled more rigorous follow-up studies of patien…
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