Acute intracranial boxing-related injuries in U.S. Marine Corps recruits : Report of two cases

Serious acute intracranial injuries from boxing are a recognized, albeit rare, event. Acute brain injuries such as concussion, hemorrhage, and contusion are easily recognized because of their rapid onset of neurological impairment. The sequelae of such injuries range from transient diminished cognitive function to irreversible brain damage and, on occasion, death. The more serious injuries are certainly minimized as a result of regulatory policy, improved medical awareness, and the use of safety equipment. The incidence of serious acute head injury in amateur boxing and noncompetitive boxing is lower than that found in the professional ranks. Our survey of instructional boxing in U.S. Marine Corps basic training during an 8-year period detected only three serious acute brain injuries incurred by approximately 180,000 participants, equating to one serious head injury per 60,000 participants. Serious head injuries constituted an extremely small percentage (0.3%) of the approximately 1,100 total boxing-related injuries surveyed during the period. We present two cases of serious acute brain injury incurred during noncompetitive boxing skills instruction as a part of U.S. Marine Corps basic training. A review of the data leads us to conclude that the risk of serious head injury in a well-supervised, instructional boxing program is relatively minimal. In any case, we recommend that any boxing be appropriately supervised and that specialized trauma care and an adequate transport mechanism to secure that care be readily available.