Neurologic aspects of boxing
B. D. Jordan
The assessment and prevention of potentially adverse neurologic
consequences of boxing requires two important considerations. Acute
neurologic injuries should be distinguished from chronic brain injuries and
the level of competitive boxing (ie, amateur vs professional) must also be
taken into account. Acute neurologic injuries such as concussion,
post-concussion syndrome, intracranial hemorrhage, and brain contusion are
more readily identified than chronic neurologic injuries because of their
immediate devastation of the nervous system. In contrast, chronic
neurologic injuries differ in their pathophysiologic mechanisms that are
exemplified by an insidious onset and progression after the cessation of
boxing. Accordingly, the chronic traumatic encephalopathy of boxing poses
the most serious neurologic threat of boxing. Amateur boxing differs from
professional boxing in the duration of fights, rules and regulatory
policies, medical evaluation, and protective devices. These factors could
produce a differential effect on the risk of injury to the brain. The
prevention of neurologic injuries in boxing requires the integration of
proper neurologic evaluation by qualified ring-side physicians, the design
and utilization of effective protective devices, and the establishment of
national regulatory agencies.
