Psychosurgery: A historical overview

NEUROSURGICAL TREATMENT FOR psychiatric disorders has a long and controvers ial history. From the Stone Age use of trephining to release the demons of the spirit to the millimeter accuracy of stereotactic instruments currently used in the operating room, psychosurgery has enjoyed enthusiastic support as well as experiencing scorn. Today, psychosurgery is a minimally invasiv e and highly selective treatment that is performed for only a few patients with severe, treatment-refractory, affective, anxiety, or obsessive-compuls ive disorders. Recent advances in technology and functional neuroanatomic t echniques, as well as economic pressures to decrease the costs of caring fo r chronically ill patients, may provide an opportunity for psychosurgery to become a more attractive option for the treatment of psychiatric diseases. In this historical overview, the rise and fall of psychosurgery are descri bed. A better understanding of the colorful history of this interesting top ic should enable modern neurosurgeons and other health care professionals t o meet the social, ethical, and technical challenges that are sore to lie a head.