Chronic Traumatic Encephalopathy

Definition

Chronic traumatic encephalopathy (CTE) is a brain disease found in people who have had repeated head injuries. It can lead to physical and mental problems that get worse over time.

Causes

Repeated head injuries can lead to a buildup of a protein called tau. These proteins create tangled masses in the brain. This causes changes in how the brain works. Tau is one of the proteins found in health issues like Alzheimer's disease and Down's syndrome.

Risk Factors

This risk of this problem is higher in people who have had past head injuries. The risk may be higher in people who:

• Played contact sports such as boxing, football, hockey, wrestling, and soccer
• Were in military combat
• Were physically abused
• Have had seizures
• Have a developmental disability and harm themselves (head banging)

Symptoms

Problems may start many years after the head injuries. They also vary from person to person. A person with CTE may have:

• Memory problems
• Confusion
• Problems with focus
• Poor decision making, such as acting without thinking
• Mood changes, such as irritability and aggression
• Lack of interest in activities
• Believing things that are not based in reality

People with severe problems may have signs of depression, such as feelings of hopelessness and suicidal thoughts.

Diagnosis

The doctor will ask about symptoms and health history. A physical exam will be done. The doctor may also ask about any past head injuries. This may be enough to suspect the diagnosis.

These tests may be done to learn more about the brain:

• Blood tests
• Lumbar puncture to check the fluid around the brain and spine
• A neuropsychological exam to learn more about how the brain works
• Images, such as:
  • CT scan
  • MRI scan
  • PET scan

The only way to diagnose CTE is for a doctor to look at the brain after a person has died.

CT Scan of the Head.

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Treatment

The goal of treatment is to manage symptoms. There is no cure for CTE. Problems may be managed with:

• Therapy and support groups
• Medicines, such as antidepressants, antipsychotics, and mood stabilizers
• Lifestyle changes, such as exercising regularly, eating a healthy diet, and avoiding alcohol and drugs

Prevention

People who have had a past head injury should not play sports until the doctor says it is safe.

The risk of this problem may also be lowered by taking steps to avoid head injury, such as:

• Wearing a seatbelt in motor vehicles
• Using safe, age-based sports methods for children
• Wearing a helmet when:
  • Playing a contact sport like football, soccer, or hockey
  • Riding a bike or motorcycle
  • Using skates, scooters, and skateboards
  • Catching, batting, or running bases in baseball or softball
  • Riding a horse
  • Skiing or snowboarding