Prevalence of Cerebral Microhemorrhages in Amateur Boxers as Detected by 3T MR Imaging

BACKGROUND AND PURPOSE: The evidence for traumatic brain injury in amateur boxers is controversial. Hypothetically, sudden acceleration of the head due to the impact of the blow during the boxing fight might result in diffuse axonal injury or contusion. We wanted to determine whether cerebral microhemorrhages occur more often in amateur boxers than in nonboxers. MATERIALS AND METHODS: In 42 male, classical amateur boxers and in 37 healthy, nonboxing male volunteers we performed cranial MR imaging at 3T. The study protocol included a transverse dual spin-echo MR imaging sequence, a 3D sagittal magnetization-prepared rapid acquisition of gradient echo sequence, a coronal T2*-weighted sequence, and an axial time-of-flight MR angiography sequence. MR imaging data were made anonymous before 2 neuroradiologists independently evaluated the images. In addition, the following risk factors were assessed: total numbers of fights and knockouts, weight division, and duration of boxing. We compared the group proportions of microhemorrhages with Fisher test of exact probability. RESULTS: There was a statistically higher prevalence of cerebral microhemorrhages in the group of boxers (3 of 42; 7.1%) than in nonboxing persons (0 of 37; 0%). This difference was not statistically significant, however (P = .2479; Fisher exact test). CONCLUSION: Although we detected more microhemorrhages in amateur boxers than in nonboxing persons, this difference did not prove to be significant.

[1]  A. Uluğ,et al.  Diffusion anisotropy changes in the brains of professional boxers. , 2006, AJNR. American journal of neuroradiology.

[2]  Edward H Livingston,et al.  Statistical power and estimation of the number of required subjects for a study based on the t-test: a surgeon's primer. , 2005, The Journal of surgical research.

[3]  K. Blennow,et al.  [There is a strong evidence that professional boxing results in chronic brain damage. The more head punches during a boxer's career, the bigger is the risk]. , 2005, Lakartidningen.

[4]  A. Collie,et al.  A prospective controlled study of cognitive function during an amateur boxing tournament , 2004, Neurology.

[5]  D Yves von Cramon,et al.  Diffuse axonal injury associated with chronic traumatic brain injury: evidence from T2*-weighted gradient-echo imaging at 3 T. , 2003, AJNR. American journal of neuroradiology.

[6]  Norman Relkin,et al.  Increased diffusion in the brain of professional boxers: a preclinical sign of traumatic brain injury? , 2003, AJNR. American journal of neuroradiology.

[7]  I. Moseley,et al.  The neuroimaging evidence for chronic brain damage due to boxing , 2000, Neuroradiology.

[8]  F Unterharnscheidt A neurologist's reflections on boxing. V. Conclude remarks. , 1995, Revista de neurologia.

[9]  F. Unterharnscheidt A neurologist's reflections on boxing. I: Impact mechanics in boxing and injuries other than central nervous system damage. , 1995, Revista de neurologia.

[10]  T. Tokuda [Boxer's brain and other types of post-traumatic dementia]. , 1993, No to shinkei = Brain and nerve.

[11]  M. Holzgraefe,et al.  The significance of diagnostic imaging in acute and chronic brain damage in boxing. A prospective study in amateur boxing using magnetic resonance imaging (MRI). , 1992, International journal of sports medicine.