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NEUROPATHOLOGIC LESIONS FOLLOWING LOBOTOMY A Study of Fifteen Cases of Bilateral Prefrontal Lobotomy
Am J Psychiatry 1953;109:808-816-5.
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The Pathological Laboratories of the Boston State Hospital, Boston, Mass.

Metropolitan State Hospital, Waltham, Mass.

Taunton State Hospital, Taunton, Mass.

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The objectives of this survey were the study of the brain changes following lobotomy and the influence of infection, toxins, systemic disease, etc., on the course of healing of the wound. The findings in the cases of long and short survival are compared and evaluated.1 The brain wound is larger than the original incision in all cases.2. The process of repair in an aseptic wound is slow and when completed results in cystic necrotic formations in the white matter of frontal lobes.3. The cortical wound heals faster than the subcortical.4. The meninges are thickened and there are often adhesions between the dura, leptomeninges, and the cortical wound.5. The process of repair may be greatly retarded by bacterial infections, toxins, focal and systemic infection, nephritis, etc., preceding or following lobotomy.6. Because of technical difficulties, more tissue is destroyed than the rationale of this treatment warrants.7. The clinical expression of this added destruction may account for many symptoms beclouding the release of tension and anxiety achieved by sectioning of the thalamofrontal fibers.

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