• Luis García-Muñoz, Ofir Picazo-Picazo, José D Carrillo-Ruíz, Jesús Favila-Bojórquez, Fernando Corona-García, Miguel Ángel Meza-Bautista, and Fiacro Jiménez-Ponce.
• Servicio de Neurología y Neurocirugía, Hospital General de México "Dr. Eduardo Liceaga", México.
• Gac Med Mex. 2019 Jan 1; 155 (Suppl 1): S62-S69.

BackgroundNeurosurgical treatment, although controversial, is considered a useful resource in the treatment of chronic psychiatric diseases such as refractory aggressiveness.ObjectiveTo evaluate the clinical results and side effects of posteromedial hypothalamotomy associated with amygdalotomy in patients with refractory aggressiveness.MethodA clinical trial was conducted in patients with chronic aggressiveness and refractory to pharmacological treatment. A central amygdalotomy associated with posteromedial hypothalamotomy was performed using thermo-coagulation by radiofrequency. The degree of aggressiveness was quantified by the Yudofsky's global scale of aggression. Postoperative changes in aggressive behavior continued to be evaluated every 6 months for at least 36 months.ResultsA statistically significant change in aggressive behavior was observed during 36 months of follow-up. The collateral effects of the association of both procedures are described, the most frequent being drowsiness and some cases of reduction in sexual behavior.ConclusionSymmetric and simultaneous unilateral lesions of the central nucleus of the amygdala and the posteromedial hypothalamus contralateral to motor dominance give the same clinical effect in the reduction of the pathological aggression that the bilateral lesions.Copyright: © 2019 SecretarÍa de Salud.

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