A case of malignant hypertension, treated with prefrontal leucotomy and psychotherapy, followed for over eight years.

Abstract

Abstract The authors describe a case of malignant hypertension treated with prefrontal leucotomy and psychotherapy. The operation took place on 5 April 1949. It was not followed by any immediate drop in blood pressure, but the patient became amenable to simple psychotherapy. In the following months and years the blood pressure dropped progressively until it reached high normal average values and the retinopathy and albuminuria disappeared. At present, eight years after the operation, the patient is still engaged in active work, although suffering from some after-effects of the operation. The authors discuss the importance of this observation for our insight into the aetiology and pathogenesis of malignant hypertension. It is suggested that the leucotomy did not act by a direct effect on the blood pressure, but by the changes it produced in the personality of the patient, especially in his attitudes towards certain of his, presumably specific, conflict situations.