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April 30, 2015: Chronic traumatic encephalopathy

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Brought to you by the Residents & Fellows Section of Neurology.

April 30, 2015

Chronic traumatic encephalopathy

Chronic traumatic encephalopathy, referred to as CTE, is a progressive neurodegenerative disease commonly resulting from repetitive brain trauma. Contact sport athletes including football, boxers and hockey players, as well as individuals involved in combat situations are most prone to this type of repetitive trauma. Insidious decline in memory function, in association with behavioral, personality changes and Parkinsonian features are all common in CTE. On gross pathological inspection, preferential atrophy is noted in the medial temporal lobes, thalamus, mammillary bodies, and brainstem, with a fenestrated cavum septum pellucidum seen in about half of cases. Pathologically, CTE is a tauopathy, similar to Alzheimer disease, with tau-immunoreactive tangles and neurites often affecting the superficial cortical layers and also having a propensity for deep sulcal depths. As there is no clinical way to diagnosis CTE, post-mortem evaluation remains the gold standard. Although CTE is more common in those who have sustained significant and prolonged brain injuries, those with mild traumatic brain injury and concussions are felt to have CTE in up to 17% of cases.

References

  1. McKee AC, Cantu RC, Nowinski CJ, et al. Chronic traumatic encephalopathy in athletes: progressive tauopathy after repetitive head injury. J Neuropathol Exp Neurol 2009; 68: 709-735.

Submitted by James Addington, M.D. Resident Physician, Department of Neurology, University of Virginia

Disclosures: Dr. Addington is a member of the Residents & Fellows Section of Neurology.

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