Cranial MR imaging of sequelae of prefrontal lobotomy - PubMed
Cranial MR imaging of sequelae of prefrontal lobotomy
A Uchino et al. AJNR Am J Neuroradiol. 2001 Feb.
Abstract
Background and purpose: Although prefrontal lobotomy is an obsolete treatment for schizophrenia, we still encounter patients who have undergone this procedure. The purpose of this study was to describe the MR imaging findings of sequelae of prefrontal lobotomy.
Methods: We retrospectively reviewed cranial MR images of eight patients with schizophrenia who underwent prefrontal lobotomy approximately 50 years previously.
Results: In all patients, a bilateral cavitary lesion with a thick wall was found in the frontal white matter. The genu of the corpus callosum was mildly to markedly atrophic. The size and location of the cavity and the degree of callosal atrophy were correlated.
Conclusion: MR imaging is useful for the diagnosis of sequelae of prefrontal lobotomy, including cavitary lesions with dense walls of gliosis and secondary degeneration of the genu of the corpus callosum.
Figures
![<sc>fig</sc> 1.](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80d9/7973933/834ec5e84aec/ajnr-22-02-13-f01.gif)
Images of patient 4. A, Axial FLAIR image shows a large bilateral cavitary lesion containing CSF-like fluid with a thick wall in the frontal white matter. The cortical sulci of bifrontal lobes are dilated mildly. The cavum septum pellucidum is also observed. B, Midsagittal T1-weighted image shows markedly atrophic genu of the corpus callosum.
![<sc>fig</sc> 2.](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80d9/7973933/2bc348efc1c7/ajnr-22-02-13-f02.gif)
Axial FLAIR image of patient 5 shows a small cavity with a thick wall in the bifrontal white matter. The bifrontal cortical sulci are dilated mildly. Moderately atrophic genu of the corpus callosum was observed on the midsagittal T1-weighted image (not shown)
![<sc>fig</sc> 3.](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80d9/7973933/3c7d8bb9b304/ajnr-22-02-13-f03.gif)
Images of patient 7. A and B, Two contiguous axial FLAIR image shows a small bilateral cavitary lesion in the medial frontal white matter. The cortical sulci of bifrontal lobes are dilated mildly. Markedly atrophic genu of the corpus callosum was observed on the midsagittal T1-weighted image (not shown).
Similar articles
-
An autopsy case of the schizophrenic 32 years after lobotomy.
Arai Y, Tsutsui Y, Shinmura Y, Kosugi T, Nishikage H, Yamamoto J. Arai Y, et al. Neuropathology. 2001 Mar;21(1):53-60. doi: 10.1046/j.1440-1789.2001.00363.x. Neuropathology. 2001. PMID: 11304043
-
Unilateral prefrontal lobotomy for epilepsy: technique and surgical anatomy.
Cossu G, González-López P, Pralong E, Kalser J, Messerer M, Daniel RT. Cossu G, et al. Neurosurg Focus. 2020 Apr 1;48(4):E10. doi: 10.3171/2020.1.FOCUS19938. Neurosurg Focus. 2020. PMID: 32234977
-
Long-term effect of prefrontal lobotomy on verbal fluency in patients with schizophrenia.
Stip E, Bigras MJ, Mancini-Marïe A, Cosset ME, Black D, Lecours AR. Stip E, et al. Brain Cogn. 2004 Aug;55(3):466-9. doi: 10.1016/j.bandc.2004.02.067. Brain Cogn. 2004. PMID: 15223191 Clinical Trial.
-
Acquired lesions of the corpus callosum: MR imaging.
Uchino A, Takase Y, Nomiyama K, Egashira R, Kudo S. Uchino A, et al. Eur Radiol. 2006 Apr;16(4):905-14. doi: 10.1007/s00330-005-0037-9. Epub 2005 Nov 12. Eur Radiol. 2006. PMID: 16284771 Review.
-
Engelborghs S, Borggreve F, Pickut BA, Michiels K, Van de Mosselaer W, De Deyn PP. Engelborghs S, et al. Acta Neurol Belg. 1998 Jun;98(2):199-203. Acta Neurol Belg. 1998. PMID: 9686281 Review.
Cited by
-
The return of the lesion for localization and therapy.
Joutsa J, Lipsman N, Horn A, Cosgrove GR, Fox MD. Joutsa J, et al. Brain. 2023 Aug 1;146(8):3146-3155. doi: 10.1093/brain/awad123. Brain. 2023. PMID: 37040563 Free PMC article.
-
Yang JC, Ginat DT, Dougherty DD, Makris N, Eskandar EN. Yang JC, et al. J Neurosurg. 2014 Jan;120(1):152-163. doi: 10.3171/2013.9.JNS13839. Epub 2013 Nov 15. J Neurosurg. 2014. PMID: 24236652 Free PMC article.
-
MR imaging of psychosurgery: rostral atrophy following stereotacic subcaudate tractotomy.
Cauley KA, Waheed W, Salmela M, Filippi CG. Cauley KA, et al. Br J Radiol. 2010 Nov;83(995):e239-42. doi: 10.1259/bjr/80389109. Br J Radiol. 2010. PMID: 20965896 Free PMC article. Review.
-
Byard RW. Byard RW. Forensic Sci Med Pathol. 2017 Jun;13(2):259-264. doi: 10.1007/s12024-017-9846-9. Epub 2017 Feb 21. Forensic Sci Med Pathol. 2017. PMID: 28220363 No abstract available.
-
Frontal lobotomy: a vanishing but important radiological finding.
Lovell B. Lovell B. BMJ Case Rep. 2015 Aug 3;2015:bcr2014208767. doi: 10.1136/bcr-2014-208767. BMJ Case Rep. 2015. PMID: 26240096 Free PMC article. No abstract available.
References
-
- Moniz E. Prefrontal leucotomy in the treatment of mental disorders. Am J Psychiatry 1937;93:1379-1385 - PubMed
-
- Freeman W, Watts JW. Retrograde degeneration of the thalamus following prefrontal lobotomy. J Comp Neurol 1947;86:65-93 - PubMed
-
- Engelborghs S, Borggreve F, Pickut BA, Michiels K, Van de Mosselaer W, De Deyn PP. Case report of a patient with complex partial frontal lobe seizures as a complication of bifrontal lobotomy. Acta Neurol Belg 1998;98:199-203 - PubMed
-
- Banna M, Adams K, Tunks E, Finlayson MAJ. Computed tomography after psychosurgery. J Comput Assist Tomogr 1978;2:98-99 - PubMed
-
- Duncan AW, Schoene WC, Rumbaugh CL. The computerized tomographic appearance of frontal lobotomy. Comput Tomogr 1980;4:255-260 - PubMed
MeSH terms
LinkOut - more resources
Full Text Sources
Medical