Chronic Traumatic Encephalopathy
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.
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.
This risk of this problem is higher in people who have had past head injuries. The risk may be higher in people who:
Problems may start many years after the head injuries. They also vary from person to person. A person with CTE may have:
- Memory problems
- 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.
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:
The only way to diagnose CTE is for a doctor to look at the brain after a person has died.
Copyright © 2002 Nucleus Communications, Inc. All rights reserved.http://services.epnet.com/getimage.aspx?imageiid=24032403si55551310.jpgCT Scan of the HeadNULLjpgCT Scan of the HeadNULL\\filer01\Intellect\images\si55551310.jpgCopyright © 2002 Nucleus Communications, Inc. All rights reserved.21NULL2002-10-012553912403_744866Copyright © Nucleus Medical Media, Inc.
The goal of treatment is to manage symptoms. There is no cure for CTE. Problems may be managed with:
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
- 2019 surveillance of head injury: assessment and early management (NICE guideline CG176). National Institute for Care Excellence (NICE). Available at: https://www.ncbi.nlm.nih.gov/books/NBK551814.
- Asken, B.M., Sullan, M.J., et al. Research gaps and controversies in chronic traumatic encephalopathy: a review. JAMA Neurology. 2017; 74 (10): 1255-1262.
- Blast anatomy—chronic traumatic encephalopathy in military vets. Alzheimer Research Forum website. Available at: https://www.alzforum.org/news/research-news/blast-anatomy-chronic-traumatic-encephalopathy-military-vets?id=3159.
- Encephalopathy information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/health-information/disorders/encephalopathy.
- Kowall, N. Chronic traumatic encephalopathy (CTE) and its connection with ALS. US Department of Veterans Affairs website. Available at: http://www.va.gov/RAC-GWVI/docs/Minutes_and_Agendas/Minutes_Nov2010_AppendixA_Presentation7.pdf.
- Moderate to severe traumatic brain injury. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/moderate-to-severe-traumatic-brain-injury.
- Prevention. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/traumaticbraininjury/prevention.html.
- Traumatic brain injury. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/health-information/disorders/traumatic-brain-injury.
- Rimas Lukas, MD
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