Magnetic resonance image-guided stereotactic cingulotomy for intractable psychiatric disease.

We describe the modern operative technique of magnetic resonance (MR) image-guided stereotactic cingulotomy and discuss the indications, results, and complications of this procedure. A retrospective analysis of psychiatric outcome was performed for 34 patients with intractable major affective disorder and/or obsessive-compulsive disorder who underwent MR image-guided stereotactic cingulotomy since 1991. Fourteen patients underwent multiple cingulotomies (50 total procedures).

Cingulotomy for intractable obsessive-compulsive disorder. Prospective long-term follow-up of 18 patients.

Background: The purpose of this study was to assess prospectively long-term change in obsessive-compulsive disorder (OCD) symptoms in patients with an OCD diagnosis that was confirmed by structured interview and with documented unsuccessful trials of multiple medications and attempts at behavior therapy.

Methods: We conducted an unblinded preoperative and follow-up assessment of comorbid diagnosis; OCD, depressive, and anxiety symptoms; and functional status in 18 patients who underwent cingulotomy.

Results: At a mean follow-up of 26.

Potentiometric determination of ionized and total calcium in blood plasma of Holstein and Jersey cows.

The effects of stage of lactation and breed on total and ionized calcium in blood plasma were determined for eight Holstein and eight Jersey cows fed a diet containing .25% Ca during the dry period and fed a diet with .50% Ca after calving.

Neurosurgical treatment of severe obsessive-compulsive disorder associated with Tourette's syndrome.

We describe two patients with Gilles de la Tourette's syndrome (TS) and disabling obsessive-compulsive and ritualistic behaviors who underwent bilateral radiofrequency anterior cingulotomy. Both achieved a limited but sustained improvement in behavioral symptoms and overall functional abilities. Our observations indicate involvement of limbic structures in this disorder.

Historical overview of psychosurgery and its problematic.

In 1936, Egas Moniz published his first paper on frontal leucotomy for psychiatric illness. The initial enthusiasm for this innovative treatment of intractable psychiatric disorders and chronic pain was soon tempered by reports of undesirable side-effects, and neurosurgeons began a search for modifications of leucotomy which would increase safety without reducing efficacy. As a result of these clinical investigations, the original imprecise, radical frontal leucotomy has been superseded by precise, small stereotactically placed lesions in the limbic system and the descriptive phase "limbic system surgery" is replacing the out-moded word "psychosurgery".

Treatment of psychiatric illness by stereotactic cingulotomy.

The treatment of 198 psychiatrically disabled patients with stereotactic cingulotomy was evaluated prospectively for a mean follow-up of 8.6 years. Patients with major affective disorders and anxiety disorders fared the best, with a return to normal functioning in the majority.

Computed tomographic analysis of bilateral cingulotomy for intractable mood disturbance and chronic pain.

Forty-two patients out of 300 who had undergone bilateral stereotactic cingulotomies were studied by means of computerized tomography (CT). The appearance showed bilateral encephalomalacia, measuring on the average 5 X 7 mm2, located in the cingulate gyrus. These induced lesions had attenuation values similar to cerebrospinal fluid and did not enhance with contrast.

Can the psro's be cost effective? A study of the effect of the Commonwealth Health Agencies monitoring program on the length of stay of Medicaid patients in Massachusetts.

To analyze the effect of the Commonwealth Health Agencies Monitoring Program on the length of stay of a sample of Massachusetts Medicaid patients, we compared their experience with that of non-Medicaid patients. We found a consistently decreasing trend in the length of stay of Medicaid patients during the 2 1/2-year period studied. The average length of stay of Medicaid patients decreased by 11.

Computed tomography in cerebral abscess.

Computed tomography (CT) scans of 9 surgically proved cases of cerebral abscess were reviewed. The CT characteristics were studied, as were the postoperative scans. Also assessed were the contributions to the diagnosis of the clinical features, plain radiographic examinations, radionuclide imaging, and angiography.