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Monday, 04 November 2013 21:34

Medically-induced coma in boxing: What is it?

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Yesterday, Russian heavyweight Magomed Abdusalamov was hospitalized and placed in a medically-induced coma, a procedure used for patients who are at high risk of serious brain injury.
So what is a medically-induced coma and why is it implemented?

When you twist your ankle or break your wrist, swelling ensues. In boxing, the brain can swell in the same fashion due to continual, violent blows to the head.

Obviously, brain swelling is usually more serious than a swollen ankle or wrist because the brain controls cognition, emotions, awareness and movement.

What also makes brain swelling more serious is the unalterable skull it's contained in.

Your skin will expand to accommodate ankle swelling but your skull won't make way for brain protuberance. As a result, intracranial pressure from brain swelling can be life-threatening because there's nowhere for the brain to go when it enlarges.

As the brain swells, the pressure generated squeezes off of the blood supply, leading to the death of even more brain tissue.

There are a few ways doctors can reduce the swelling and pressure without inducing a coma. For example, like putting ice on a swollen ankle to reduce swelling, doctors will cool the body to about 90 degrees to achieve the same effect on the brain.

Administering an induced coma, or a state of deep unconsciousness, is usually the last resort yet it's not uncommon.

An anesthesiologist gives the patient a barbiturate or a sedative (like propofol) to force the brain to rest. In this scenario, the patient is literally "knocked out" and unresponsive to all external stimuli i.e. pain, light, noise and etc.

By reducing as much brain activity as possible, swelling reduces (or slows) while doctors monitor it and determine how long to keep the fighter in that state.

Unfortunately, this process is not always benign. Patients, as a result of the induced coma, can come out of it with full or partial muscle paralysis, pneumonias or blood clots. And sadly, this procedure can, in extreme cases, leave patients in a vegetative state.

On a lighter note, some patients, after awakening, report experiencing intense nightmares and hallucinations while others have no significant ill-effects.

Can a boxer fight again after serious brain swelling and an induced coma?

Well, nothing is impossible. However, a boxer's return to the ring after serious swelling of the brain and an induced coma is, unfortunately, improbable.

At this point, the objective is to mitigate any complications caused by the swelling and/or any subsequent ailments produced by the coma.

If the fighter is physically, mentally and emotionally the same person he was prior to the ordeal that, in itself, is considered a major win.

Even after a (presumed) full recovery, it's unlikely a fighter will be able to obtain a license to fight because he will be considered high risk.

While swelling of the brain may not "necessarily" predispose a fighter to more swelling, it's believed he'll be more compromised should he suffer another brain injury. As a result and even in the best possible scenario, no relevant boxing commission is likely to take that chance.


This is not the opinion of a medical professional or someone even close. Always consult a physician or medical expert if you think you have a serious head injury, have detailed questions about medically-induced comas, or need professional advice about resuming your fighting career after experiencing such an ordeal.