Neurology pictorial: Scars of psychosurgery: frontal lobotomy

Abstract

Frontal lobotomy, a form of psychosurgery popular in the 1930s to 1950s, involved severing white matter tracks to and fro from the prefrontal cortex . There were many modifications of the basic procedure. The American neurologist Walter Freeman popularized the transorbital frontal lobotomy in which electroconvulsive therapy was used for anesthesia and then an ice-prick resembling instrument called the leucotome was inserted into the orbital roof by lifting the upper eyelid 2, . A hammer or a mallet was then used to drive the leucotome through the thin layer of orbital bone into the patient’s brain. The leucotome was then swept across from side to side severing the connections of the prefrontal cortex.