A lobotomy is a neurosurgical procedure; a form of psychosurgery that consists of cutting the connections to and from the prefrontal cortex (gif - highlighted red). It was a mainstream procedure for more than two decades, prescribed for psychiatric (and occasionally other) conditions—this despite general recognition of frequent and serious side-effects.
Early lobotomies were performed by drilling a holes in the skull either side of the prefrontal cortex and injecting alcohol to destroy the connecting fibres between certain areas of white and grey brain matter. This technique often destroyed other parts of the brain and led to complications.
In a later procedure, Dr. Montiz used a tool called a leuctome, which is inserted into the brain through a hole in the skull and then a plunger on the back of the leucotome is depressed to extend a wire loop or metal strip into the brain. The leucotome is then rotated, cutting a core of brain tissue.
The procedure was then further developed by Walter Freeman, who discovered a simpler way to sever the connections to the pefrontal cortex, by using an ice pick and hammer. The ice pick would be placed behind the eye socket, and the thin layer of bone would be broken through by hitting the end of the pick with the hammer, driving the instrument into the frontal lobes. The pick would then be swung to sever the frontal lobes (contains dopamine sensitive neurons - associated with reward, attention, short-term memory tasks, planning, and motivation) from the thalamus (functions include regulation of consciousness, sleep, and alertness).
In 1948, Freeman embellished the procedure by adding the deep frontal cut, an additional swing of the pick deep into the lobe which placed such an increase of strain on the instrument that it occasionally snapped off while in the patient's head, necessitating surgical retrieval. Thus, Freeman had the orbitoclast specially commissioned as a more durable and reliable replacement.
'Ice Picks' used for the procedure, called Orbitoclasts.
