Abstract
Since professional boxing is associated with substantial risk of both acute and chronic traumatic brain injury, many athletic (boxing) commissions in the United States and abroad request a neuroimaging study of the brain to determine brain fitness to fight. Either magnetic resonance imaging (MRI) brain or computed tomography (CT) head is needed to obtain a license to compete in professional combat sports and periodically thereafter. The neuroimaging study helps to identify and/or exclude structural brain lesions that may pose a risk of rupture or bleeding from head impact exposures (HIEs) sustained during the course of the bout. Identification of structural brain lesions such as large tumors, vascular malformations such as aneurysms, arteriovenous malformations, and large cavernous malformations results in a denial of licensure to fight. Pineal gland cysts (PC) are usually benign cysts discovered on occasions incidentally in MRI scans of boxers. A 25-year-old asymptomatic boxer was found to have a 2 cm PC with intracystic hemorrhage on MRI scan done for licensure. The medical literature was reviewed to determine whether boxers with PC can safety compete in combat sports.