psychosurgery /-sur″jərē/ [Gk, psyche + cheirourgia] , surgical interruption of certain nerve pathways in the brain, performed to treat selected cases of chronic unremitting anxiety, agitation, or obsessional neuroses. Modern psychotherapeutic drugs have replaced psychosurgery in most cases. Psychosurgery is performed when the condition is severe and when alternative treatments, such as psychotherapy, drugs, and electroshock, have proved ineffective. The procedure may be a limited prefrontal lobotomy, in which connecting fibers in the frontal region are cut, or a modified bifrontal tractotomy, in which nerve tracts of the brainstem are severed. Light general anesthesia is given. Postoperative nursing care includes observation for signs of leakage of cerebrospinal fluid. A marked alteration of personality is unavoidable. Various cognitive and affective functions also are affected, depending on the location of the induced lesion, the extent of destruction of nerve tissue, and the age, sex, and condition of the patient.
