Russian boxer's plight shows dangers of combat sports

Magomed Abdusalamov is a professional heavyweight fighter who has reached the highest level of his sport. On Nov. 2, 2013, two hours after a brutal 10-round decision loss at Madison Square Garden, Abdusalamov became comatose and remains hospitalized.

Combat sports include boxing and a variety of mixed martial arts contests.  Points are usually scored by successfully neurologically impairing an opponent.

Little has been revealed about Abdusalamov’s injuries other than the fact that he suffered a brain hemorrhage.  Based on descriptions, he most likely suffered an epidural hemorrhage.

An epidural hemorrhage often results from tearing the middle meningeal arteries after a skull fracture.  Blunt trauma is the most common cause as opposed to a concussion that is usually caused by rapid acceleration and deceleration of the brain. Headgear is more effective in avoiding skull fractures and hemorrhages than it is in avoiding concussion.

Epidural hemorrhages are arterial in origin and therefore occur quickly and with large volumes of blood making them especially serious if not detected quickly. A typical presentation includes a brief loss of consciousness followed by a lucid period during which the hemorrhage expands.  This is followed by a deep coma.

During the lucid period, there are few findings to raise suspicion of this deadly condition.

Treatment includes removing the blood and part of the skull to allow the brain to swell without causing deadly levels of pressure within the closed cranium.  Patients are often placed in a medically-induced coma to slow brain metabolism and control swelling.

Abdusalamov has now emerged from coma and has hopefully begun the long process of rehabilitation that includes retraining the brain to perform basic functions like speaking and eating.

This tragedy serves as a grim reminder that combat sports are more than the difference between a win or loss but may be life or death.