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Psychosurgery, the surgical alteration or permanent removal of brain tissue to alleviate severe psychological conditions, stands as one of the most radical and controversial treatments in the history of mental health care. Its development and application have evolved significantly, marked by dramatic shifts in scientific understanding and ethical perspectives.
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Related Experiment Video

Updated: May 23, 2026

Investigating the Function of Deep Cortical and Subcortical Structures Using Stereotactic Electroencephalography: Lessons from the Anterior Cingulate Cortex
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Investigating the Function of Deep Cortical and Subcortical Structures Using Stereotactic Electroencephalography: Lessons from the Anterior Cingulate Cortex

Published on: April 15, 2015

The frontotemporal (pterional) approach: an historical perspective.

Tamer Altay1, William T Couldwell

  • 1Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA. altaytamer@hotmail.com

Neurosurgery
|April 5, 2012
PubMed
Summary

The pterional (frontotemporal) approach is a versatile neurosurgical technique, refined over a century. It provides access to complex brain regions for treating tumors and vascular issues.

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Area of Science:

  • Neurosurgery
  • Cranial Surgery

Background:

  • The pterional (frontotemporal) approach is a cornerstone neurosurgical technique.
  • Its evolution spans over a century with contributions from numerous neurosurgeons.

Observation:

  • Current pterional approach involves drilling the sphenoid wing to the superior orbital fissure.
  • Anterior clinoid removal, orbital roof thinning, and opening Sylvian fissure/basal cisterns are key features.
  • This approach grants access to a wide range of cranial pathologies.

Findings:

  • The pterional approach is highly effective for treating tumors and vascular lesions.
  • It offers access to the sellar/parasellar area, circle of Willis, and middle cerebral artery.
  • Lesions of the insula, basal ganglia, mesial temporal region, and optic nerve are also treatable.

Implications:

  • The pterional approach remains the most frequently utilized transcranial method in neurosurgery.
  • Understanding its evolution and modifications is crucial for contemporary neurosurgical practice.
  • Derivative procedures extend the utility of this foundational surgical access.