ABSTRACT
Four patients with neuroradiological evidence of normal pressure hydrocephalus and psychiatric diagnosis of affective psychoses with major depression--like characteristics are presented. Three patients underwent shunting operations following an observation period of 2 to 6 years. During the post-operative follow-up of 3 to 7 years, resp., no clinical changes were noted. In our opinion, and following critical evaluation of the available literature, major depression--like affective disorders in normal-pressure hydrocephalus are not influenced by shunting operations, unless they occur simultaneously as an additional symptom in an Adams-Hakim syndrome with definite progression.
Subject(s)
Affective Disorders, Psychotic/psychology , Hydrocephalus, Normal Pressure/psychology , Neurocognitive Disorders/psychology , Affective Disorders, Psychotic/surgery , Combined Modality Therapy , Family Therapy , Female , Follow-Up Studies , Humans , Hydrocephalus, Normal Pressure/surgery , Male , Middle Aged , Neurocognitive Disorders/surgery , Postoperative Complications/psychology , Ventriculoperitoneal ShuntABSTRACT
The report of the surgical curative effect in 37 cases of chronic and aggressive behaviour psychoses. The cerebral amygdaloid nucleus and the cinguli bundle were damaged in the part by the cerebral stereotaxic operation. Through we have been evaluated strictly and follow-up survey for 2 years, that shown 67% in the effective rate, the behaviour and hallucination were recovered especially. Select the operative target and some medicine administration in the period of postoperation about improve the curative effect are significant especially also.
Subject(s)
Schizophrenia/surgery , Adult , Affective Disorders, Psychotic/surgery , Amygdala/surgery , Female , Gyrus Cinguli/surgery , Humans , Male , Middle Aged , Stereotaxic TechniquesABSTRACT
Forty-two patients out of 300 who had undergone bilateral stereotactic cingulotomies were studied by means of computerized tomography (CT). The appearance showed bilateral encephalomalacia, measuring on the average 5 X 7 mm2, located in the cingulate gyrus. These induced lesions had attenuation values similar to cerebrospinal fluid and did not enhance with contrast. CT is a useful technique for initial evaluation, management, and follow up of these patients.
Subject(s)
Affective Disorders, Psychotic/surgery , Gyrus Cinguli/diagnostic imaging , Pain, Intractable/surgery , Tomography, X-Ray Computed , Chronic Disease , Depressive Disorder/surgery , Gyrus Cinguli/surgery , Humans , Stereotaxic TechniquesABSTRACT
Cholinergic prevalence together with a monaminergic deficit characterize the neurotransmitter imbalance underlying psychotic depression. Correction of this neurotransmitter imbalance is the principal purpose and goal of all treatment methods for the relief of psychotic depression. This can be accomplished by reducing the acetylcholine predominance or increasing the level of monaminergic functioning, or a combination of both approaches. The antidepressant tricyclic drugs combine a central anticholinergic action with an aminergic potentiating function. Electroconvulsive therapy is effective through activation of both cholinergic and aminergic systems, with removal of excess acetylcholine into the cerebrospinal fluid. Psychiatric surgery restores neurotransmitter balance by blocking excessive acetylcholine synthesis and activity.
