Acute on Chronic Subdural Hematoma in a Female Boxer: A Case Report
Abstract
INTRODUCTION: Although the sport of female boxing has a long history, the activity's current popularity is unprecedented. As more women participate, we can expect them to experience many of the serious neurologic injuries observed in their male counterparts. We present the first reported subdural hematoma in a female secondary to boxing and critique management decisions made by the athlete's trainer/coach. CASE REPORT: A 24-yr-old right-handed female boxer developed headaches of increasing intensity, nausea, and emesis after being knocked down while sparring. She was allowed to continue training despite persistent symptoms and participated in a match 2 wk after the incident that was stopped due to intolerable headache. Computed tomography scan of the brain revealed a large heterogeneous subdural fluid collection over the left cerebral hemisphere, causing effacement of the adjacent sulci and a large left-to-right midline shift, consistent with an acute on chronic subdural hematoma. After surgical evacuation, the patient reported persistent memory, concentration, and language problems. Neuropsychological evaluation was performed and revealed deficits in confrontational naming, information retrieval, and concentration difficulty. DISCUSSION: Several factors may increase the female participants' risk for acute neurological injury. The activity's current popularity and high demand with fans results in rapid advancement of inexperienced fighters, which leads to dangerous mismatches. Intergender sparring is common, and return to competition guidelines utilized for male participants are often not adhered to. This report is timely in that female athletes are more often crossing into previously male dominated sports and should serve as a reminder that these participants are vulnerable to similar injuries. Previous safety guidelines should be utilized in this new population of participants.
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The most common cause of death or disability in sports-related head injury is subdural hematoma.
“Of these, the most common cause of death or disability in sports-related head injury is subdural hematoma [113, 133].”
From The neuropathology of sport (2014) · cites this paper as [133]
Second-impact syndrome occurs when an athlete sustains an initial mild head injury or concussion, then suffers a second head injury before the symptoms associated with the first impact have cleared, with resultant diffuse cerebral swelling and grave deterioration.
“Second-impact syndrome (SIS) occurs when an athlete sustains an initial mild head injury or concussion, then suffers a second head injury before the symptoms associated with the first impact have cleared, with resultant diffuse cerebral swelling and grave deterioration [19, 20, 113, 133, 137, 164].”
From The neuropathology of sport (2014) · cites this paper as [133]
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- Authors
- MIELE, V. J., CARSON, L., CARR, A., & BAILES, J. E.
- Affiliations
- West Virginia University (US)
- ORCID
- BAILES, JULIAN E.
- Venue
- Medicine & Science in Sports & Exercise
- Published
- 2004-11
- Volume
- 36
- Issue
- 11
- Pages
- 1852-1855
- ISSN
- 0195-9131 (ISSN-L)
- OpenAlex
- W2068504379
- Cited by
- 24
- References
- 4
- Citations by year
- 2024: 1 · 2023: 3 · 2022: 1 · 2021: 1 · 2020: 1 · 2017: 1 · 2016: 1 · 2015: 3 · 2013: 1
- FWCI
- 1.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medicine & Science in Sports & Exercise (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Neurology › Neurosurgical Procedures and Complications
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
- Keywords
- sports-related head injury, female athletes, neuropsychological deficits
- MeSH terms
- Adult, Athletic Injuries, Boxing, Brain, Craniotomy, Emergency Medicine, Female, Humans, Nervous System Diseases, Radiography, Glasgow Coma Scale, Head Injuries, Closed, Treatment Outcome, Hematoma, Subdural, Acute, Hematoma, Subdural, Chronic
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