Rare Case of Bilateral Cerebellar Hemorrhage in a Male Boxer.

Pramod Theetha Kariyanna,Mohammed Al-Sadawi,Apoorva Jayarangaiah,Muhammad Faizan Ahmed,Sushruth Das,Madina Abduraimova,Samy I Mcfarlane,Alix Charles

doi:10.12691/ajmcr-7-10-4

Abstract

The sport of boxing carries with it the risk of brain injury with acute and chronic neurological injuries such has contusion, concussion and intracranial bleeding has been reported. The force sustained from a boxing blow can be as powerful as being hit with a 6-kg wooden mallet striking at 20 mph. Bilateral cerebellar hemorrhage secondary to trauma is a rare entity that has not been reported in the literature previously. One can only speculate as to how a boxer could potentially develop a cerebellar bleed. Regardless of whether a very powerful punch or the act of falling back and hitting the occipital region directly on the floor, it is very likely that a predisposing factor exist. We present you a rare case of a 26 year-old male boxer who was knocked out in a boxing match and was noted to have acute parenchymal and subarachnoid hemorrhage bilaterally in the cerebellar hemispheres. Our report highlights the need to consider cerebellar bleed in boxers who present after ataxia after boxing/knocked out.

Highlights

Case PresentationThe sport of boxing carries with it the risk of brain injury [1]. Cerebral microhemorrhages [2], brain stem hematoma [3], subdural hematoma [4] with boxing have been previously reported
Acute neurological injuries include concussion, intracranial hemorrhage, brain contusion and traumatic brain injury is among the chronic neurological changes from boxing [6]
We present you a rare case of a 26 year-old male boxer who was knocked out in a boxing match and was noted to have acute parenchymal and subarachnoid hemorrhage in bilateral cerebellar hemispheres

Summary

Case Presentation

The sport of boxing carries with it the risk of brain injury [1]. Cerebral microhemorrhages [2], brain stem hematoma [3], subdural hematoma [4] with boxing have been previously reported. We present you a rare case of a 26 year-old male boxer who was knocked out in a boxing match and was noted to have acute parenchymal and subarachnoid hemorrhage in bilateral cerebellar hemispheres. A 26 year old male presented with unsteady gait after he was knocked out in a boxing match He was wearing a protective headgear it slid during the match and subsequently, multiple strikes were sustained to the face and head. He was awake with Glascow Coma Scale score (GCS) of 14 but had some memory impairment. Computed tomography (CT) of the head revealed acute parenchymal and subarachnoid hemorrhage in bilateral cerebellar hemispheres; left greater than right with surrounding edema (Figure 1). Magnetic resonance imaging of brain revealed subarachnoid hemorrhage in the cerebellar hemispheres bilaterally with moderate surrounding edema (Figure 2). Normal in the C4-T1 distributions bilaterally, and the L2/S1 distributions bilaterally

Discussion

Findings

Conclusion