Neurological Injuries in Boxers: The Use of Tests-Reply

Abstract

In Reply.— We disagree with Drs Charnas and Pyeritz. First, we do not think a careful neurological history and neurological examination alone are sufficient screening tools to detect chronic brain injury in boxing. At the New York State Athletic Commission, on countless occasions, boxers have had either an abnormal electroencephalogram and/or cranial computed tomographic (CT) scan with normal findings on neurological examinations. In addition to detecting chronic brain injury in boxing, the electroencephalogram and CT scan are used to identify those boxers who are at increased risk of an acute catastrophic neurological event in the ring. In our study of CT and magnetic resonance imaging comparisons, patient 5 had a large arachnoid cyst of the quadrigeminal plate that was compressing the brain stem. This arachnoid cyst, which could be potentially life-threatening if it were to sustain additional trauma, would have gone undetected if it were not for a prelicensing