Jason Stephens | May 14, 2021 | Brain Injuries
Chronic traumatic encephalopathy (CTE) is a progressive, degenerative brain disease. CTE results from repeated brain injuries. Tackle football is a leading cause of CTE. But CTE can also arise from other contact sports like boxing, hockey, and soccer. Doctors have even found CTE in members of the armed forces and other occupations with repeated exposure to blast waves.
Doctors cannot cure CTE. Tragically, they cannot even diagnose it until after the patient dies and they can dissect the brain. CTE causes behavioral changes, such as emotional outbursts and depression. It also causes visible damage in the brain similar to that of Alzheimer’s Disease.
Today, we’ll take a deep dive into CTE and its connection to football.
How Does CTE Develop?
As its name suggests, chronic trauma leads to CTE. A layer of cerebrospinal fluid cushions your brain inside your skull. When you bump your head, the fluid disperses the force so that your brain does not absorb the impact. The viscosity of the fluid also slows down the motion of your brain. This prevents your brain from striking the inside of your skull.
But scientists have found that repeated bumps on the head affect your brain. Chronic bumping does not need to cause concussions to damage the brain.
The brain contains tau proteins that provide structure. They also help to deliver nutrients to the brain by forming microtubules. You can think of tau proteins like the steel in the girders and pipes of a building.
When the brain takes an impact, the tau proteins loosen. Repeated impacts cause the structures to break apart.
The body replaces the tau proteins, but the replacement proteins have a different structure. They tend to clump together. Rather than providing structure, they gum up the brain.
What Are the Symptoms of CTE?
CTE produces progressive, degenerative symptoms, meaning CTE symptoms worsen over time.
Some of the most common symptoms of CTE include:
- Emotional outbursts
- Impulsive behavior
- Poor judgment
The same clumped tau proteins that characterize CTE also appear in the brains of seniors with Alzheimer’s Disease. This explains why the progression of dementia in CTE patients mirrors that of Alzheimer’s patients.
How Do Doctors Diagnose CTE?
Doctors can only find the tau proteins that characterize CTE after death. Doctors slice the brain and dye it. They take images of the brain slices and search the images for tau proteins. If the tau proteins appear systematically through the brain, the patient had CTE.
Although doctors can only diagnose CTE after death, they can identify suspected cases of CTE based on a patient’s symptoms.
Doctors assume a patient has CTE when the patient:
- Exhibits behavioral and mental problems associated with CTE
- Falls within a category of people at risk for CTE
Doctors watch for signs of CTE in patients involved in boxing/fighting sports, football, hockey, and soccer. All these activities can result in repeated blows to the head. They may also suspect CTE in service members, miners, and other people who are routinely exposed to blast waves from explosions.
How Do You Treat CTE?
Doctors cannot cure CTE, but doctors, therapists, and caregivers can help patients to:
- Slow disease progression
- Treat symptoms
- Assist daily activities
CTE patients can take the same medications used to treat memory loss for Alzheimer’s patients. Similarly, doctors can prescribe medication to treat behavioral symptoms like depression.
Is CTE Preventable?
Since doctors have no cure for CTE, they have emphasized prevention instead. Some doctors have recommended that parents refrain from registering their children in contact sports leagues. Repeated child injuries, particularly head injuries, can accumulate to cause CTE.
For those who do play contact sports, doctors recommend using a helmet and mouthguard. Professional football players often do not wear a mouthguard to protect their teeth. However, the mouthguard might play an important role in reducing the force transmitted to the brain from head blows.
You can also reduce the risk of CTE by following a head injury protocol from a doctor. Playing too soon after a head injury exposes you to the cumulative effects of chronic brain trauma.
Connections Between CTE and Football
The statistics connecting CTE are so shocking that many parents avoid tackle football for their children. In a study by Boston University (BU) and the Department of Veteran’s Affairs, 96% of the brains donated by former football players had CTE.
Another study by BU found that the risk of developing CTE doubles every 2.6 years of a football player’s career. This means that a student who makes the freshman team and plays all through high school will graduate with more than twice the risk of CTE than a student who did not play high school football.
The Aaron Hernandez Case
The case that shifted the public’s view of CTE and football was that of Aaron Hernandez. Hernandez was an all-American football player in college. The New England Patriots drafted Hernandez, and he played professionally for three years. By all measures, he was a standout player.
After his third professional season, he was arrested for murder. In total, he was indicted and tried on three murders. A jury convicted him of one murder and sent him to prison. A later jury acquitted him of the other two murders.
Hernandez killed himself in prison five days after his acquittal. After his death, scientists examined his brain and found that at age 27, he already had Stage III CTE. The scientists said that they had never seen a brain with as much damage at his age.
Doctors will never know whether Hernandez’s legal problems came from his CTE. But many doctors gave opinions in interviews that they found it difficult to believe that the CTE had no relationship to his behavior.
Legal Remedies for CTE
People with CTE can recover compensation for their injuries. But difficulties can arise in determining who to sue, how to establish their liability, and what defenses they might raise.
When someone voluntarily engages in a dangerous activity, they may lose the right to sue for injuries due to known risks. If you have CTE or know someone with CTE, you should consult with an injury lawyer to discuss your legal options.