Pugilist's Dementia

By Stuart M. Smith, MD and B. James McCallum, MD

Float like a butterfly, sting like a –wait, what was I talking about? Also known as punch drunk syndrome or chronic traumatic encephalopathy, pugilist's dementia is a brain injury that comes from being punched in the head hundreds of times.

The condition develops over a period of years, with the average time of onset being about 12-16 years after the start of a career in boxing. It usually manifests as declining mental abilities, or dementia, and has tremors and poor coordination and bears more than a passing resemblance to Parkinson's disease.

Boxing headgear may help, but contrary to popular belief, boxing gloves are actually designed to prevent injury to the puncher, not the punchee – they are designed to prevent Boxer's fracture. Also known as the brawler's fracture, this is the common name for a fracture at the neck of the fifth metacarpal bone or "pinky knuckle". This knuckle tends to lead the rest of the knuckles in a hard punch, it compresses and snaps the head of the metacarpal bone.

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