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March 1960

Radiofrequency Leukotomy for Relief of PainCoagulation of Medial Frontal White Fibers in Stages by Means of Inlying Electrodes

AMA Arch Neurol. 1960;2(3):317-330. doi:10.1001/archneur.1960.03840090081010

In order to avoid the serious forms of psychological deterioration which invariably followed bilateral transection of the frontal white matter in attempts to relieve otherwise intractable pain, Grantham4 proposed bilateral electrocoagulation of the inferior medial quadrants. This he carried out by means of fine unipolar electrodes, insulated down to the terminal centimeter, which were inserted through paramedian trephine openings 6 to 7 cm. behind the glabella. The lesion was made by means of the standard operating-room electrodesiccation unit. Thereby lesions of small extent can be made, the needles withdrawn, and the transverse incision sutured. When this technique is used, it is generally necessary to reinsert electrodes of this type a number of times and increase the size of the lesion in progressive stages. Grantham and Spurling5 reported a number of cases in which pain was well relieved without serious psychological damage or risk of other complications, such as

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