Personality Changes After Rostral Leucotomy: a Comparison with Standard Prefrontal Leucotomy

Abstract

“Standard” leucotomy in the plane of the coronal suture is undoubtedly an effective treatment for many cases of otherwise hopeless prognosis. The main objection to its use, resulting in many “modified” operations being devised, has been the occurrence of serious personality deficits afterwards. Ström-Olsen and Tow (1949) found that these handicapped nearly three-quarters of patients with “severe neurotic depression, obsessive-compulsive neurosis and chronic tense hypochondriasis”, and though 76 per cent. were relieved of illness only 8 per cent. were in full employment. Tow (1952) has repeated his concern at the serious damage inflicted on well-preserved personalities. Partridge (1950), who has given a full account of the personality changes after McKissock's (1943) “standard” leucotomy, detected some personality deficit in nearly every case of the 300 he investigated and suspected that intellectual impairment was present in all, though he could only be sure of it in a proportion. I have elsewhere (Pippard, 1955) reported the clinical results in 240 cases followed up 1½ to 5 years after rostral leucotomy by Mr. McKissock and this paper should be consulted for details of the operative techniques and scales used for rating the results.