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June 1970

Open Mesencephalotomy and Thalamotomy for Intractable Pain.

Arch Neurol. 1970;22(6):572. doi:10.1001/archneur.1970.00480240092013

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In this small monograph the author presents a lucid review of the gross and microscopic neurologic and vascular anatomy of the mesencephalon and thalamus before comparing techniques and results of his experience and that of others with both stereotactic and open mesencephalotomy, mesencephalothalamotomy, and thalamotomy for intractable pain problems. The principal value in his presentation, however, lies in his description of 51 personal cases which contribute to the sparse total literature in this field. The limitations of each of these procedures are evident as he describes in detail the clinical results; these are the development of hyperpathia following mesencephalic procedures and the short-term beneficial results of thalamotomy in the treatment of central pain. The author also describes a novel procedure of partial longitudinal separation of the medial and lateral thalamic groups which he feels is superior to supplemental dorsomedial thalamotomy. He contends that there are fewer psychiatric sequelae of this

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