Modern neurosurgery for psychiatric disorders

被引:63
作者
Binder, DK
Iskandar, BJ
机构
[1] Univ Calif San Francisco, Dept Neurosurg, San Francisco, CA 94143 USA
[2] Univ Wisconsin, Dept Neurosurg, Madison, WI USA
关键词
capsulotomy; cingulotomy; limbic leukotomy; psychosurgery; subcaudate tractotomy;
D O I
10.1097/00006123-200007000-00003
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
OBJECTIVE: The evolution, rationale, and results of modern functional neurosurgery to treat psychiatric disorders are documented. The potential benefits of neurosurgical treatment for selected, critically ill, psychiatric patients are considered. METHODS: The history, anatomic features, and evolution of and contemporary indications for the four currently used procedures (cingulotomy, subcaudate tractotomy, limbic leukotomy, and capsulotomy) are reviewed. Available outcome, neuropsychological assessment, and functional imaging data are presented. RESULTS: Recently, there has been a renaissance of interest in the surgical treatment of psychiatric disease. Modern psychiatric neurosurgical procedures are quite safe, with extremely low surgical mortality rates and transient postoperative morbidity. In selected cases, patients with conditions that had previously been completely refractory to comprehensive medical and behavioral intervention demonstrated significant improvement. This improvement was usually observed in the absence of long-term adverse neuropsychological consequences. CONCLUSION: Recent outcome studies, together with advances in neurobiology, psychiatry, functional imaging, and stereotaxy, support the further investigation of modern functional neurosurgical procedures to treat psychiatric disorders and their application for a subset of psychiatric patients with conditions refractory to all other therapies.
引用
收藏
页码:9 / 21
页数:13
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