{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:56:34Z","timestamp":1787025394327,"version":"build-2736575974"},"reference-count":24,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Impulsive aggression is the core symptom of intermittent explosive disorder, which can be a feature of several psychiatric disorders. There is a subset of individuals who do not respond adequately to medical treatment; they are treatment refractory. The objective of this report is to describe a case of a patient with a background of schizophrenia and concomitant refractory aggressiveness disorder, treated with two-stage bilateral hypothalamotomy and unilateral amygdalotomy with Gamma Knife radiosurgery (GKR).<\/jats:p>\n <\/jats:sec>\n \n Case Description:<\/jats:title>\n A 36-year-old male presented with a background of paranoid schizophrenia. Episodes of self- and hetero-aggressiveness were present at the initial diagnosis. High dosages of psychotropic medication were taken, and 70 sessions of electroconvulsive therapy were performed; however, no adequate response was obtained. Bilateral hypothalamotomy plus left amygdalotomy through GKR was performed. After 25 months of follow-up, a marked decrease in the frequency, degree, severity of aggressiveness and the requirement for psychotropic medications was observed.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Hypothalamotomy plus amygdalotomy with Gamma Knife may be an effective ablative technique for the management of refractory aggressive disorder in patients with mental illness.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_860_2024","type":"journal-article","created":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T00:31:10Z","timestamp":1734654670000},"page":"469","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Bilateral hypothalamotomy plus dominant amygdalotomy with Gamma Knife radiosurgery. A non-invasive alternative when everything has failed in the management of aggressive behavior disorder"],"prefix":"10.25259","volume":"15","author":[{"given":"Oscar I. Molina","family":"Romero","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Fundaci\u00f3n Cl\u00ednica Shaio, Bogot\u00e1, Colombia"},{"name":"Neurosurgery Program, Universidad El Bosque, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Diez-Palma","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Fundaci\u00f3n Cl\u00ednica Shaio, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"Fonnegra-Caballero","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Fundaci\u00f3n Cl\u00ednica Shaio, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"Segura-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Fundaci\u00f3n Cl\u00ednica Shaio, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Matinez-Alvarez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Gamma Knife Radiosurgery, Hospital Ruber Internacional, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar","family":"Yamhure","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Instituto Colombiano del Sistema Nervioso - Cl\u00ednica Monserrat, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian Felipe","family":"Camargo","sequence":"additional","affiliation":[{"name":"Neurosurgery Program, Universidad El Bosque, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio Roberto","family":"Fonnegra-Pardo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Fundaci\u00f3n Cl\u00ednica Shaio, Bogot\u00e1, 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