title: [Punch drunk syndrome due to repeated karate kicks and punches].
abstract: We reported a 39-year-old man with punch drunk syndrome who had cerebellar ataxia, seizure and dementia. CT scan of the brain revealed remarkable atrophy and enlargement of the ventricular system. MRI of the brain showed severe atrophy which was especially evident in the frontal base. On RI cisternography both early ventricular reflux at 3 hours and delayed ventricular stasis at 52 hours were found, which resembled the findings of the normal pressure hydrocephalus. The MRI and RI cisternographic findings suggested that the remarkable brain atrophy and enlargement of the ventricular system were caused by repeated KARATE traumas including minor brain contusion or subarachnoid hemorrhage in the base of the brain, since traumatic brain contusions affect particularly the orbital surfaces of the frontal lobes and the lateral and inferior surfaces of the temporal lobes. Communicating hydrocephalus may be one of the pathogenesis of punch drunk syndrome.
authors.affiliation: Department of Neurology, Chiba University School of Medicine.
authors.forename: A
authors.initials: A
authors.lastname: Aotsuka
authors.forename: S
authors.initials: S
authors.lastname: Kojima
authors.forename: H
authors.initials: H
authors.lastname: Furumoto
authors.forename: T
authors.initials: T
authors.lastname: Hattori
authors.forename: K
authors.initials: K
authors.lastname: Hirayama
mesh_terms: D000328:Adult; D001284:Atrophy; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D001924:Brain Concussion / Q000175:diagnosis; D001930:Brain Injuries / Q000150:complications*; D002524:Cerebellar Ataxia / Q000209:etiology*; D003704:Dementia / Q000209:etiology*; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000175:diagnosis / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D016139:Martial Arts / Q000293:injuries*; D011877:Radionuclide Imaging; D012640:Seizures / Q000209:etiology*; D013577:Syndrome