Abstract

Professional boxing is a combat sport associated with a substantial risk for both acute and chronic traumatic brain injuries (TBI). Acute traumatic subdural hematoma (SDH) is the most common cause of boxing related mortality. Boxers usually collapse in the ring or in the immediate aftermath of a bout. In case of a large traumatic SDH, an emergency decompressive hemicraniectomy may be a lifesaving procedure but leaves the boxer with significant and permanent neurological deficits. Chronic neurological injuries associated with boxing usually encompass the sequelae of multiple head impact exposures (HIEs) which the boxer sustains over the course of his professional career. These include chronic headaches, chronic dizziness, chronic post-concussion syndrome, Parkinsonism, punch drunk syndrome, dementia pugilistica and chronic traumatic encephalopathy (CTE). Should a boxer who has suffered and survived a traumatic SDH in the ring with no residual neurological deficits, be allowed to box professionally ever again?

Keywords

traumatic subdural hematoma, emergency decompressive, traumatic encephalopathy, neurological deficits, craniotomy, good fusion, Neuroimaging guidelines