Management of head injuries

Editor - The article in the May issue on the management of head injuries¹ states that the medial temporal lobe may herniate under the falx, causing compression of the oculomotor (3rd cranial) nerve. This is not the case; medial temporal lobe herniation is transtentorial, although it may compress the 3rd nerve. The cingulate gyrus may herniate under the falx, leaving the 3rd nerve well alone.

1. Turner K, Jones A, Handa A. Emergency management of head injuries. studentBMJ 2000;8:140-2. (May.)

Authors' reply

Editor - We thank Mr Preston for his comments; he is correct. Compression of the oculomotor nerve occurs when the medial temporal lobe herniates through the tentorial incisura. We apologise that our article did not make this clear.

Kevin Turner, research fellow in urology , John Radcliffe Hospital, Oxford
Email: kevin@kkturner.freeserve.co.uk


studentBMJ 2000;08:303-346 September ISSN 0966-6494