Medico-legal implications of acute subdural haematoma in boxing

A 16-year-old male high school student with a history of fever (38-39 degrees C) for 4 days lost consciousness following the end of a three round boxing match. He was transferred to a neurosurgical unit located 48 km away 1 h 36 min after injury. Clinical assessment at the unit revealed a comatose patient with a left acute subdural haematoma, but because of advanced brain oedema surgical management was deemed futile. At autopsy an acute subdural haematoma and a severe brain oedema were confirmed. Evaluation of physical conditions before the fight should have been more rigorous in our patient. The observations in our case support the published literature that boxing matches should be held only where neurosurgical expertise is readily available.