If a boxer has suffered a subdural hematoma, my personal advice, having survived a subdural hematoma several years ago, is never return to the ring?
?Boxing is the only sport in which the objective is to render blows to the head and body of the opponent so as the cause the opponent to be incapacitated.??Various medical sources
?An injury that caused the brain to hemorrhage is as bad as it gets? Not many guys get a second chance. If you are lucky enough to have recovered from a bleeding brain ? Get on your knees and thank whatever God you follow? To allow guys to take shots at your head, in a boxing ring is crazy? Beyond crazy even.??Poster named Eddie F (Yahoo Answers)
?I couldn?t put my socks on. Now they say I?m a miracle.??Kieran Farrell
?A few weeks after the fight, I was still affected by the damage that was done?My speech was a little bit off. I was slurring a little bit. But after about two months, I cleared up and I have my wits about me now.??Timothy Bradley
?Step in just once to punish the people responsible for knowingly allowing a fighter who?s on medical suspension to fight. If that happened, people would start toeing the line. Things would change real fast. But the federal government has made it clear to us again and again that it simply isn?t interested in enforcing federal law as it relates to boxing.??Tim Lueckenhoff, president of the Association of Boxing Commissions
In boxing, the most common life-threatening injury encountered by its participants is subdural hematoma (SDH), a rupturing of the veins between the brain and the skull; and the most dreaded (and longer range) consequence of chronic insult to the nervous system is dementia pugilistica. (SDH) often requires surgical intervention. Neurologists are working to make boxing safer by trying to pinpoint subtle changes in examinations and scans that portend serious future damage in order to whisk fighters out of the ring in time.
In July 2007, Michael Katsidis and Czar Amonsot waged a brutal 12-round head snapping war in Las Vegas. Czar suffered a subdural hematoma (bleeding on the brain) thus presumably ending his boxing career in the United States. During the same bruising card, Oscar Larios suffered a similar injury against Jorge Linares. Larios eventually returned to boxing fighting three times in Mexico and twice in Japan before calling it quits in March 2009 with a fine 63-7-1 record. Meanwhile, Amonsot, after an 18-month layoff, also returned and has now gone 7-0-2 against moderate opposition since his savage encounter with Katsidis. Six of his fights have been in Australia and three in the Philippines.
Jermain Taylor says he has ?nothing else to do.? He has now fought four times since being knocked unconscious by Carl Froch and Arthur Abraham in 2009. Taylor has already suffered a subdural hematoma; he is playing the same dangerous game as ?The Great One? and the ?Czar.? Says Kevin Iole, ?It?s time for Jermain Taylor to say when, no matter how many tests he?s passed. Boxing is about to get him. This is a fight that he cannot win.? (Yahoo Sports, December 13, 2013)
The case of Joe Mesi who was injured badly when he fought and beat Vassiliy ?The Tiger? Jirov in 2004 has been vetted. According to Thomas Hauser, reportedly one of the few outside the Mesi camp to see a report on Joe?s MRI exams, ?the first MRI exam on March 17 showed a left parietal hematoma pressing on the left side of Joe Mesi?s brain. A March 25 MRI exam apparently was misread and the problem appeared to be resolved. However, the next MRI exam on April 8 showed two subdural hematomas that went undetected in initial readings. The next MRI exam on April 27 showed the two subdural hematomas were still present. Mesi finally had a clean MRI exam on May 27.?
After two years of countless medical examinations and mind numbing courtroom battles to be allowed back into the ring, Joe took advantage of a legal technicality that allowed him to get boxing licenses in Puerto Rico, Louisiana, Arkansas, Michigan, and Rhode Island. Against the advice of his friends, fans, and writers, he returned to fight and thankfully, his last five bouts lasted a total of only nine rounds against opponents who were limited at best. Joe finally retired undefeated (35-0), but more importantly with his health intact.
In my view, what Mesi did and what the others are doing may be one of many forms of Russian roulette that boxing entails.
Controversy
?There?s no evidence he?s [collision-sport athlete] at greater risk for a brain bleed than if he ever had the first brain bleed?and that?s the reason we?ve got many athletes playing football, rugby ? all kinds of sports ? that have gone back after a subdural hematoma, especially one that did not require surgical incision.??Robert Cantu, Chief of Neurosurgery and Director of Sports Medicine at Emerson Hospital in Concord, Mass.
Significant controversy exists over how to use the medical information available regarding subdural hematomas. In fact, some, like the highly respected Vincent Miele, Julian Bailes, Robert Cantu, and Craig Rabb, cite the cases of Marco Antonio Barrera and the late Edwin Valero as examples of boxers who successfully returned to competition after brain issues and argue that more research is essential to objectify the reasoning behind possibly ending an athlete?s career and livelihood. See Subdural Hematomas in Boxing: The Spectrum of Consequences. Neurosurg Focus. 2006; 21(4)
Others assert the contrary. As Dr. Margaret Goodman, former head of the Nevada Medical Advisory Board and Nevada State Athletic Commission (NSAC) says, ?I?m of the philosophy that if a fighter has suffered a cerebral hemorrhage, they should never fight again. So few fighters suffers bleeds, that they must have some predisposition. So to put them in harm?s way again, whether they fought one more time or five more times, is just playing Russian roulette with their life.? (RingTV.com / 2.14 Page 78)
Renowned boxing doctor John Stiller, Chief Physician-Md State Athletic Commission and Director of Neurology Service at St. Elizabeth?s Hospital, Washington, DC, also drives home the point of zero tolerance.
?If a boxer sustains a subdural hematoma (SDH) while boxing, he/she should NEVER be licensed to box again. The argument that if the boxer recovers ?completely? in that he/she passes all exams/tests, then that boxer is no more likely to have another SDH than any other boxer, ignores the possibility of an increased susceptibility. This should be obvious in that the boxer already sustained an SDH after passing all exams/tests. If the boxer is fortunate to recover from an SDH, he/she should be grateful and not tempt fate. Francisco Leal may well be alive today if he was not licensed to box again after suffering an SDH in Texas [against Evengy Gradovich on March 31, 2012].?
Going Forward
Until more is known about the long-term effects of subdural hematomas and whether they put someone at greater risk of experiencing another, there will continue to be controversy over whether athletes with a history of hematomas should be allowed to compete. In this regard, I believe Nevada may have changed its policy and will now license a boxer who has suffered a SDH while boxing as long as he or she passes all requirements for licensing. The statement that was made by a physician for the commission was essentially that if the boxer passed all the tests he/she would be no more likely to sustain an SDH than any other licensed boxer. Of course the individual who made that statement has no convincing data to support it. A more candid statement would be they don?t know if the individual would be at increased risk. I further believe New York has followed suit.
Notwithstanding the fact that dealing with brain injuries is a complex and not-so-exact science (and acknowledging the two sides to the controversy), I?ll nevertheless go with the fail-safe (zero tolerance) position of Drs. Goodman and Stiller to wit: There is a cogent argument that the individual would be at increased risk. At the end of the day, no neurologist will say that being struck in the head is good. In my view, that goes double for a SDH survivor?
Suffice it to say that if a boxer has suffered a subdural hematoma or cerebral edema, my personal advice, having survived a subdural hematoma several years ago, is never return to the ring, never.
Russian Roulette: Part One Russian Roulette: Part Two
Ted Sares is a private investor who enjoys following and writing about boxing. A member of the Elite Powerlifting Federation, Ted actively competes in the sport throughout the US and Eastern Canada and holds several state records for his age class.
