Chronic Traumatic Encephalopathy: A Potential Late Effect of Sport-Related Concussive and Subconcussive Head Trauma
Section snippets
Clinical signs and symptoms of CTE
Whereas concussion and postconcussion syndrome represent temporary states of neuronal and axonal derangement, CTE is a neurodegenerative disease that occurs years or decades after recovery from the acute or postacute effects of head trauma. The exact relationship between concussion and CTE is not entirely clear, although repetitive axonal perturbation may initiate a series of metabolic, ionic, membrane, and cytoskeletal disturbances, which trigger the pathologic cascade that leads to CTE in
Gross Pathology
Neuropathologic studies of athletes with a history of repeated mild head injuries have produced several consistent findings that, together, make CTE a distinctive disorder. On gross examination, there is often anterior cavum septi pellucidi and, usually, posterior fenestrations. These changes may be caused by the force of the head impact being transmitted through the ventricular system, thereby affecting the integrity of the intervening tissue. Enlargement of the lateral and third ventricles is
CTE is a Potential Late Effect of Repeated Head Injuries
CTE is not thought to be a long-term sequela after a specific head trauma. Rather, its clinical symptoms emerge later in life, usually after athletes retire from their sport. Like most other neurodegenerative diseases that cause dementia, CTE has an insidious onset and gradual course. Based on a recent review of neuropathologically confirmed CTE in athletes11, the mean age at onset is 42.8 years (SD = 12.7; range = 25–76 years). On average, onset occurs approximately 8 years after retirement
Summary
CTE is a neurodegenerative disease that occurs later in the lives of some individuals with a history of repeated head trauma. The exact relationship between repetitive mild TBI, with or without symptomatic concussion, and CTE is not entirely clear, although it is possible that repetitive axonal injury sets up a series of metabolic, ionic, and cytoskeletal disturbances that trigger a pathologic cascade, leading to CTE in susceptible individuals. CTE has been reported in association with American
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This work was supported by NIA P30AG13846, Supplement 0572063345-5, National Operating Committee on Standards for Athletic Equipment, and by the Department of Veterans Affairs. This work was also supported by an unrestricted gift from the National Football League. The funding sources were not involved in the preparation, review, or approval of this article.