Functional Stereotactic Neurosurgery for Psychiatric Disorders: an Experience in Belgium and The Netherlands

Part of the Advances and Technical Standards in Neurosurgery book series (NEUROSURGERY, volume 21)


This chapter addresses the difficult and often contentious subject of psychosurgery which has been defined as “a neurosurgical intervention to sever fibres connecting one part of the brain with another, or to remove or destroy brain tissue with the intent of modifying or altering severe disturbance of behaviour, thought content or mood”. The authors have traced the historical development of psychosurgery and brought out the fact that it is those patients suffering from anxiety, depression and obsessive compulsive illness who throughout this history of psychosurgery have benefited most. They also refer to the “taming effects” of the old leucotomy (obsolete since the mid-1950’s) which had proved useful in the management of certain behaviour disorders of schizophrenia. This latter effect often left patients with severe blunting of personality, but the operation, judged in the context of the alternatives available at the time was better than nothing for this unfortunate group. It allowed 20% to return to life in the community. However, as the authors emphasize this became history with the discovery in the 1950’s of the major tranquilizers and effective pharmacological agents for the treatment of depression and anxiety which has transformed psychiatry. Nonetheless, some patients remain resistant to the newer treatments and it is this which keeps an interest in psychosurgery alive. The introduction of stereo-tactic techniques, increasingly accurate imaging techniques for target identification and precise lesions have all contributed to a very low morbidity of modern procedures. It is now well recognised that Psychiatrists and Neurosurgeons must work in close partnership to ensure the cases are appropriately selected.


Obsessive Compulsive Disorder Obsessive Compulsive Disorder Obsessive Compulsive Disorder Patient Orbital Roof Dorsomedial Nucleus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag/Wien 1994

Authors and Affiliations

  1. 1.University of AntwerpenAntwerpBelgium
  2. 2.University Hospital of GentGhentBelgium
  3. 3.Hospital for Psychotheraphy “Overwaal”LentThe Netherlands
  4. 4.University Hospital of UtrechtUtrechtThe Netherlands
  5. 5.Catholic University of LeuvenLouvainBelgium
  6. 6.Academic Medical CenterAmsterdamThe Netherlands
  7. 7.University Hospital of GroningenGroningenThe Netherlands
  8. 8.Psychiatric Hospital “Ursula Kliniek”WassenaarThe Netherlands

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