The Surgical Uncertainties of Prefrontal Topectomy and Leucotomy (Observations on 100 Cases)

Abstract

Three is no branch of neuro-surgery in which the assessment of results is more difficult than in psycho-surgery. The main sources of uncertainty are: (a)Mental impairment or improvement cannot yet be measured as precisely as neurological disorders, such as visual field or motor defects. (b)Spontaneous recovery and the influence of the incidental psychotherapy and drugs involved in any form of surgical attention cannot be evaluated with certainty in many cases. (c)Most of the cytoarchitectural fields of the frontal cortex cannot yet be defined during life by any physiological test or anatomical measurement. (d)Finally, from a technical point of view the surgeon is liable to produce many incidental lesions which cannot be ascertained during the patient's life.