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Because not all blows to the head are the same
  1. É C Falvey 1 , 2,
  2. P McCrory 3
  1. 1 Department of Medicine, University College Cork, Ireland, Irish Amateur Boxing Association, Dublin, Ireland
  2. 2 Sports Surgery Clinic, Dublin, Ireland
  3. 3 The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre—Austin Campus, Heidelberg, Victoria, Australia
  1. Correspondence to Dr P McCrory, The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre—Austin Campus, 245 Burgundy Street, Heidelberg Vic 3084 Australia; paulmccr{at}

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This case illustrates a specific medical risk with this rule change where an amateur boxer suffered an acute subdural haematoma following an Amateur International Boxing Association (AIBA) sanctioned event.

Boxing, by its very nature, carries a risk of injury, particularly brain injury. Within amateur boxing, the AIBA is the international sporting federation that has the governance and medical oversight of all Olympic and international competition. AIBA has been mindful of boxers’ health and has instituted a number of rule changes over the past six decades that have been aimed at improving safety and reducing the injury risk for boxers.1

AIBA has recently changed its rules to remove helmets and head protectors for international competition and is currently proposing similar rule changes for helmets not to be used at the 2016 Rio de Janeiro Summer Olympics Games. The removal of head protectors in amateur boxing has the potential to increase head and brain injury rates and it is prudent to consider the evidence for and against such a proposed change at this level of competition.2

A critical issue in interpreting the available evidence about the use of headgear for preventing head injuries in sport over time is that headgear rules have coincided with other rule changes or implementation that could also have influenced head injury risk.1 Furthermore, the proposed rule changes may change the nature of the way amateur boxing is conducted, which in turn may result in more head impacts from both glove and head to head contact.

This case illustrates a specific medical risk with this rule change where an amateur boxer suffered an acute subdural haematoma following an AIBA sanctioned event.

Case report

A 22-year-old male boxer with 5 years senior international experience was competing in a multinational event in the 54 kg division. He won the competition having …

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  • Competing interests Paul McCrory is a co-investigator, collaborator, or consultant on grants relating to mild traumatic brain injury (TBI) funded by several governmental organisations. He is directly employed by the National Health & Medical Research Council of Australia and is based at the Florey Institute of Neuroscience and Mental Health. He is co-chair of the Australian Centre for Research into Sports Injury and its Prevention (ACRISP), which is one of the International University Research Centres for Prevention of Injury and Protection of Athlete Health supported by the International Olympic Committee (IOC). He is co-chair of the International Concussion in Sport Group. He has a clinical and consulting practice in general and sports neurology. He receives book royalties from McGraw-Hill and was employed in an editorial capacity by the British Medical Journal Publishing Group from 2001–2008. He has been reimbursed by the government, professional scientific bodies, and sporting bodies for travel costs related to presenting research on mild TBI and sport-related concussion at meetings, scientific conferences, and symposiums. He received consultancy fees in 2010 from Axon Sports (US) for the development of educational material (which was not renewed) and has received research funding since 2001 from CogState Inc. He has not received any research funding, salary or other monies from the Australian Football League, FIFA or the National Football League. The Australian Football League funds research at the Florey Institute under a legal memorandum and Dr McCrory does not receive any money from this industry funded research research. Dr McCrory serves on the AFL Concussion Working Group in an honorary capacity. McCrory is a cofounder and shareholder in two biomedical companies (involved in eHealth and Compression garment technologies) but does not hold any individual shares in any company related to concussion or brain injury assessment or technology. With regard to boxing, Dr McCrory has served since 2001 in an honorary capacity on the medical commission of the Professional Boxing and Combat Sports Board for the Victorian State Government (Australia) and was a member of the International Olympic Committee looking at the role of boxing helmets and received both travel funds as well as research funding related to this role. He did not receive any form of financial support directly related to this manuscript.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data sharing statement NA No additional unpublished data.