Chronic Traumatic Encephalopathy

Chronic Traumatic Encephalopathy

(CTE)

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.

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 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 your symptoms and health history. A physical exam will be done. You will be asked about any past head injuries. This may be enough to suspect the diagnosis.

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

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

Breast self-exam, step 5
Copyright © Nucleus Medical Media, Inc.

Treatment

Researchers are looking for ways to treat CTE. Problems may be managed with:

Prevention

People who have had a past head injury should wait to return to 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

RESOURCES:

Boston University Center for Traumatic Brain Injury
http://www.bu.edu/cste
Concussion Legacy Foundation
https://concussionfoundation.org

CANADIAN RESOURCES:

Ontario Brain Injury Association
http://www.obia.on.ca

References:

Asken BM, Sullan MJ, DeKosky ST, 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:
...(Click grey area to select URL)
Accessed January 21, 2021.
Encephalopathy information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Encephalopathy-Information-Page. Accessed January 22, 2021.
Inserra CJ, DeVrieze BW. Chronic traumatic encephalopathy. In: Stat Pearls [Internet]Treasure Island (FL). 2020.
Kowall N. Chronic traumatic encephalopathy (CTE) and its connection with ALS. US Department of Veterans Affairs website. Available at:
...(Click grey area to select URL)
Accessed January 22, 2021.
Moderate to severe traumatic brain injury. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/moderate-to-severe-traumatic-brain-injury. Accessed January 22, 2021.
National Institute for Health and Care Excellence (NICE). Head injury: assessment and early management. NICE 2017 Jun:CG176.
Prevention: What Can I do to Help Prevent Concussion and other forms of TBI? Centers for Disease Control and Prevention website. Available at:
...(Click grey area to select URL)
Accessed January 22, 2021.
Traumatic brain injury: hope through research. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Traumatic-Brain-Injury-Information-Page. Accessed January 22, 2021.
Last reviewed December 2020 by EBSCO Medical Review Board Rimas Lukas, MD
Last Updated: 1/22/2021

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