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A Boxer’s Fatal Blow


ollowing the Boston Marathon bombing in April, scientists called for an autopsy on the brain of one suspect, the deceased older brother. Dr. Robert Cantu and Dr. Robert Stern, co-founders of the Center for the Study of Chronic Traumatic Encepalopathy at Boston University, say that an autopsy could help determine if Tamerlan Tsarnaev suffered boxingrelated brain damage. We cannot begin to know what evil lurks in the hearts of men and what motivates some to commit atrocities, but we have learned much more about the human brain and the damage caused by repeated head trauma. Chronic traumatic encephalopathy (CTE) is a condition found increasingly in athletes engaged in contact sports, especially boxing and football. Tamerlan, who had been boxing since childhood, had become an outstanding Golden Gloves boxer. Even with protective headgear, the American Academy of Neurology says, intentional trauma to the brain—the kind boxers inflict—results in measureable, persistent damage, some of which appears long after the boxing ceases. The damage can manifest itself in diminished motor and cognitive skills as well as behavior. AAN, the international association of more than 21,000 neurology professionals, considers boxing a serious threat, and it urges steps to reduce the number of direct blows to the head and to increase the monitoring of participants’ neurological health. The Australian Medical Association is even stronger in its opposition. Boxing, it feels, should be banned from the Olympic and Commonwealth Games as well as prohibited for those under the age of 18. In their combined position statement, the American Academy of Pediatrics and the Canadian Paediatric Society vigorously oppose boxing for any child or adolescent. In 1983, the editor of the Journal of the American Medical Association, Dr. George Lundberg, created controversy when he called for a ban on boxing. For both medical and moral reasons, Lundberg still urges an end to the “barbaric” sport whose goal is to inflict maximum harm on the opponent. The amalgam of physiological, psychological, social, and cultural factors that shape human behavior preclude our fully understanding the Marathon bomber’s state of mind. But a look to his brain could provide useful information. Bomber No.1 may be one more boxing loser.

Participants in boxing are at risk of head, face, and neck injuries, including chronic and even fatal neurologic injuries. Concussions are one of the most common injuries that occur with boxing. Because of the risk of head and facial injuries, the American Academy of Pediatrics and the Canadian Paediatric Society oppose boxing as a sport for children and adolescents. These organizations recommend that physicians vigorously oppose boxing in youth and encourage patients to participate in alternative sports in which intentional head blows are not central to the sport. ------------------------Concussions are particularly concerning in children and adolescents, because there is evidence that a child's brain is more vulnerable to injury and that recovery from concussion is prolonged when compared with adults. — Policy Statement, “Boxing Participation by Children and Adolescents,� American Academy of Pediatrics, Council on Sports Medicine and Fitness, Canadian Paediatric Society, Health Active Living and Sports Medicine Committee, 2011.

A Boxer's Fatal Blow  
A Boxer's Fatal Blow  

Although human motivation remains a mystery, no doubt remains about the brain damage caused by repeated head trauma.