Psychosurgery: from ablation to neuromodulation / 上海交通大学学报（医学版）

Psychosurgery, the neurosurgical treatment for psychiatric disorders, has a long and controversial history. The review introduces the birth of psychosurgery, the rise and fall of the frontal lobotomy and the transition to the modern era of psychosurgery, due to the development of the stereotactic instruments, and the different psychosurgical procedures. Today, recent advances in neuromodulation may provide an opportunity for psychosurgery to become a more attractive option for the treatment of psychiatric diseases. Current states in China and prospects of psychosurgery are also discussed.

Egas Moniz: twice a double life / Egas Moniz: uma dupla vida dupla

Egas Moniz is credited with the discovery in 1927 of radioarteriography, for which he was, on three occasions, nominated for the Nobel Prize, and in all three denied the award. In 1949 he was awarded the Nobel Prize for Medicine for having designed leucotomy, a brain surgery to treat some forms of severe metal disorders. He was also an successful politician and accomplished statesman.

Egas Moniz foi o inventor da radioarteriografia, em 1927. Devido a essa descoberta, seu nome foi, por três vezes, indicado para receber o Prêmio Nobel de Medicina e, nas três, não foi considerado merecedor do prêmio. Em 1949 finalmente ele recebeu o Nobel por ter concebido a leucotomia, um procedimento cirúrgico para “tratar certos transtornos mentais graves”. Ele foi, ainda, um homem político e um estadista de sucesso.

Egas Moniz (1874-1955): cultura e ciência / Egas Moniz (1874-1955): culture and science

Por ocasião do sexagésimo aniversário da atribuição, em 1949, do prêmio Nobel da Medicina ou Fisiologia a Egas Moniz e a Walter Rudolf Hess, foram evocadas as circunstâncias que explicam a singular nobelização. Chama-se atenção para os traços biográficos de Egas Moniz, que são também os de muitos médicos da sua geração, asssim como dos pormenores que se prendem com o processo de nomeação e avaliação científica visando à candidatura ao prêmio Nobel. São também discutidos aspectos de ligação entre a cultura e a ciência, designadamente as controvérsias à volta do prêmio que lhe foi atribuído.

On the occasion of the sixtieth anniversary of the award in 1949, the Nobel Prize in Physiology or Medicine granted to Egas Moniz and Walter Rudolf Hess, the circumstances that explain the unique Nobel award require elucidation. Attention is drawn to the biographical traits of Egas Moniz, which are also those of many doctors of his generation, as well as the details which relate to the process of nomination and scientific appraisal to be eligible for the Nobel Prize. Aspects of the link between culture and science are also discussed, including the controversies surrounding the award conferred upon him.

Egas Moniz e a neurocirurgia brasileira / Egas Moniz and the Brazi l ian neurosurgery

Relata-se a trajetória científica de Egas Moniz com ênfase em suas relações com a neurocirurgia brasileira.

This work presents a summary of the scientific career of Egas Moniz with an emphasis on his impact on Brazilian neurosurgery.

Surgical Experience of Stereotactic Psychosurgery for Psychiatric Diseases

The authors report surgical experiences in patients with severe psychiatric illness refractory to all other conventional treatments. All 5 patients in this series were referred from their own psychiatrists. One patient with aggressive-conductive disorder, who was cared for in a closed ward, underwent bilateral amygdalotomy and bifrontal leucotomy. Four patients with obsessive-compulsive disorder were treated by limbic leucotomy, which is a combination of subcaudate tractotomy and anterior cingulotomy. Target points were selected according to the individual symptoms of each patients. Target construction was performed under ventriculogram or computerized tomographic guidance, using a Hitchcock stereotactic frame. All the procedures were performed under local anesthesia, except for the patient with aggressive-conductive disorder for whom the surgery had to be performed under general anesthesia because of the incooperative nature of the patient. The result of each surgery was good without serious complication. During the follow-up period, all the patients were freed from disturbing symptoms and successfully returned to their premorbid social life. Psychosurgery can be helpful in certain patients with severe, chronic, disabling, and treatment-refractory psychiatric illness.

Surgical Experience of Stereotactic Psychosurgery for Psychiatric Diseases

The authors report surgical experiences in patients with severe psychiatric illness refractory to all other conventional treatments. All 5 patients in this series were referred from their own psychiatrists. One patient with aggressive-conductive disorder, who was cared for in a closed ward, underwent bilateral amygdalotomy and bifrontal leucotomy. Four patients with obsessive-compulsive disorder were treated by limbic leucotomy, which is a combination of subcaudate tractotomy and anterior cingulotomy. Target points were selected according to the individual symptoms of each patients. Target construction was performed under ventriculogram or computerized tomographic guidance, using a Hitchcock stereotactic frame. All the procedures were performed under local anesthesia, except for the patient with aggressive-conductive disorder for whom the surgery had to be performed under general anesthesia because of the incooperative nature of the patient. The result of each surgery was good without serious complication. During the follow-up period, all the patients were freed from disturbing symptoms and successfully returned to their premorbid social life. Psychosurgery can be helpful in certain patients with severe, chronic, disabling, and treatment-refractory psychiatric illness.