Use of a mobile CT scanner at professional boxing and MMA events: making combat sports safer

Professional boxing and mixed martial arts (MMA) are popular contact sports with high risk for both acute and chronic traumatic brain injury (TBI). Although rare, combatants have died in the ring/cage or soon after the completion of the bout. The cause of death in these cases is usually acute subdural hematoma, acute epidural hematoma, subarachnoid haemorrhage, intracranial haemorrhage, or second-impact syndrome (SIS). Neuroimaging or brain imaging (either CT scan or MRI brain) is currently included in the process of registering for a license to fight in a combat sport in most commissions in the United States and around the world. Neuroimaging in the immediate aftermath of a bout primarily serves to rule out acute traumatic brain injury. At present if concern for acute TBI in a combatant is raised either during or after the conclusion of a bout, based on the neurological evaluation by the ringside physician, the fighter is immediately transported via on-site ambulance to the nearest Level I trauma center for urgent CT scan head and neurosurgical intervention if deemed necessary. Some TBIs may not manifest immediately or manifest in a subtle fashion so as to escape detection by the ringside physicians in the immediate aftermath of a bout. In this commentary the use of a mobile CT scanner at professional boxing and MMA events is proposed with the intention of making these sports safer.