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Features of craniocerebral trauma in boxers

Rules of competitions in Boxing permitted strikes glove in the lower jaw, temples, neck, liver area, solar plexus, heart. A clean victory in the ring is such a victory, when one of the boxers displays partner of the fight by knockout. Knockouts and knockdowns* cause both physical and psychological trauma.
From all variety of posttraumatic symptoms observed in athletes, highlight 4 clinical variants of post-traumatic stress disorder: 1-organic symptoms; 2 - vestibular disorders; 3 - vegetative-vascular disorders; 4 - neuropsychiatric disorders.
Characteristic features for the 1st group is a violation of the functions of cranial nerves (entreprise), pathologic reflexes, nystagmus, blanching disk of optic nerves, veins or narrowing of the arteries, increased intracranial pressure. Vestibular disorders (2nd group) after craniocerebral traumas identified by clinical examination, and at the rotation of the chair baranyi (otolith sample Century by the Imperial Vojacek) and clinically characterized by the violation of statistical equilibrium (sample Romberg simple and complicated), the presence of spontaneous nystagmus. At rotation in the chair baranyi most athletes with injuries severe and moderate marked somatic and especially vegetative reactions. Athletes with symptoms of vestibular disorders functions often complain of headaches, dizziness, fatigue.
Vascular disorders (group 3) clearly manifested in unfavourable conditions (intoxication, infection, repeated trauma, high physical activity, acclimatization). The main mechanism of vegetative-vasomotor changes is considered a violation of diencephalic and stem autonomic centers and reticular formation. Clinically, these disorders are manifested in the form of post-traumatic vasaputi with characteristic complaints of headaches pulsating character, a sense of the tide of blood to the head, chills, increased body temperature. The athletes of this group in 32 % of cases observed adverse ortoclinostatic test, glitseridy reflex of Dagnini-Achnera, in 85 % of cases there is a General and local hyperhidrosis.
Of neuropsychiatric disorders after traumatic brain injury (4) there are asthenic syndrome (37,3%), traumatic encephalopathy (12,8%), traumatic epilepsy (4.1 per cent).
The 7,9 % of the athletes after a closed skull injury there were pains in the heart area. On the electrocardiogram in some of them had been a breach of conductivity.
It should be noted that in athletes who have had repeated craniocerebral trauma, often develop diseases of internal organs (hospital disease stomach and duodenal ulcers, stenocardia, hypertension, a breach of fat metabolism and so on). The emergence of various somatic diseases in young trained the people who had a concussion of the brain, appears to be associated with damage and dysfunction of the nuclei of the hypothalamus.
The majority of domestic and foreign authors point to the possibility of occurrence after a closed brain injury or other symptoms of organic disorders, mental disorders, post-traumatic subdural and epidural hematomas and even deaths.
The clinical picture of remote consequences of traumatic brain injury in boxers has its own characteristics. Usually the fighters spent in the ring at least 5 years, you begin to complain of discomfort, which begins with feelings of weakness, mostly in the legs. They often gradually developing the syndrome of post-traumatic encephalopathy, which in different countries is called differently. In the USA it is called "punch drunk" or "slapp hарру", in West and East Germany "weichen Birne", in Italy "suonati campane". G. La Cava (1963) calls this disease Boxing disease.
The syndrome of post-traumatic encephalopathy may occur in 3 forms: extrapyramidal, the pyramid and the psychic. Extrapyramidal form is characterized by tremor individual body parts, amonia, wrong position of the head, the General and local akinesia, i.e., revealed the Parkinson's syndrome. In the pyramid shape is observed spastic paraparez, hypertension muscles, General fatigue. As for the psychic, it is mental disability, boxer becomes euphoric or lethargic, apathetic, reduced their intellectual level.

* Knock-out". knock out a shot, shibumi feet (knock - strike, strike and out - out, over - the impossibility for the fighter to continue the fight). Knockdown (eng. knock down) - a crushing blow (from knock - hit, hit, down - down). Knockdown standing-the so-called state of groggy; from the English name of the drink "grog", i.e. poliopareia state by loss of consciousness for a split second and the loss of the space orientation.