Dementia in a retired world boxing champion: case report and literature review.
OBJECTIVE
Dementia in retired boxers, also referred to as "dementia pugilistica" (DP), is usually attributed to repeated concussive and subconcussive blows to the head. We report the case of a former world boxing champion whose progressive cognitive decline could be ascribed to DP, cerebral infarcts and Wernicke-Korsakoff syndrome. This case demonstrates that dementia in retired boxers may be caused and/or exacerbated by etiologic factors other than DP.


METHODS
We correlated the clinical features with the histochemical and immunohistochemical changes observed on autopsy brain material from a retired boxer, reviewed the literature on boxing-related dementia, and compared our findings with previous reports on DP.


RESULTS
Neuropathologic examination revealed numerous neurofibrillary tangles (NFTs), rare neuritic plaques (NPs), multiple cerebral infarcts, fenestrated septum pellucidum, atrophic and gliotic mamillary bodies, and pale substantia nigra and locus ceruleus.


CONCLUSIONS
Our neuropathologic data confirmed the notion that dementia in retired boxers could be due to several factors such as DP, multiple cerebral infarcts and Wernicke-Korsakoff syndrome. Our findings illustrate the need to comprehensively examine former boxers with dementia as well as carefully evaluate the neuropathologic changes that may cause or contribute to the patient's cognitive and behavioral symptoms. Such an approach is crucial in order to provide prompt and more definitive therapies.
Nowak
L A
LA
Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013, USA.
Smith
G G
GG
Reyes
P F
PF
D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications; D001914:Boxing / Q000293:injuries*; D001930:Brain Injuries / Q000150:complications / Q000473:pathology*; D002544:Cerebral Infarction / Q000209:etiology / Q000473:pathology; D003324:Coronary Artery Disease / Q000150:complications; D003704:Dementia / Q000209:etiology* / Q000473:pathology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D006333:Heart Failure / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D007150:Immunohistochemistry; D020915:Korsakoff Syndrome / Q000209:etiology / Q000473:pathology; D008297:Male; D016874:Neurofibrillary Tangles / Q000473:pathology; D058225:Plaque, Amyloid / Q000473:pathology