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Chronic Traumatic Encephalopathy
Published in Alexander R. Toftness, Incredible Consequences of Brain Injury, 2023
Chronic traumatic encephalopathy, or CTE, is a disorder in which your brain deteriorates over time, usually because of multiple small head traumas (Mariani et al., 2020). The repeated head impacts do not necessarily need to cause symptoms of concussion—that is, they can be repeated milder subconcussive impacts (Baugh et al., 2012). It can also develop after a single severe blow to the head (e.g., Bieniek et al., 2021; Omalu & Hammers, 2021). In other words—and of all the facts in this book this one should come as the least surprising—getting hit in the head is bad for your brain.
Contact sport and blast-related neuropathology
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
Daniel du Plessis, Christopher Milroy
A number of clinical features have been reported in association with CTE (Iverson et al. 2018). These include memory impairment, attention and concentration difficulties, language impairment and visual-spatial difficulties. Behavioural features include difficulties with impulse control and aggression, disinhibition and socially inappropriate behaviour, and paranoia. There may be mood changes, depression, anxiety, apathy and suicidal ideation. Gait disorders, speech slowing and extrapyramidal signs may be present (Gardner et al. 2014).
The advent of subconcussion and chronic traumatic encephalopathy
Published in Brian Sindelar, Julian E. Bailes, Sports-Related Concussion, 2017
In 2005, Omalu et al. published a seminal paper describing the pathological evidence of what was termed “Chronic Traumatic Encephalopathy” (CTE). This was described in a former NFL player who displayed a progressive mental decline with a myriad of cognitive, behavioral, and mood symptoms.1 Over the past decade, an eruption of inquiry and scrutiny has surrounded the entity of CTE including the diagnosis, cause, and potential link with those sports at high risk of repetitive head trauma. Though scientific literature has exposed a relationship between repetitive head trauma and CTE for over a decade, the National Football League publically acknowledged its existence in March of 2016, after many years of contesting the presented data.2 Unfortunately, our knowledge of this medical diagnosis remains incomplete, as there is limited prospective evidence to better evaluate its epidemiology. Due to the relatively small number of studied cases and conflicting results, the relationship between clinical symptoms and pathological disease burden continues to be highly debated.
Efficacy of infliximab in treatment-naïve patients with stricturing small bowel Crohn’s disease
Published in Scandinavian Journal of Gastroenterology, 2021
Bing-xia Chen, Ze-min Han, Qian Zhou, Hong-bin Liu, Pei-chun Xu, Fa-chao Zhi
After a median 38 months follow-up, an effective infliximab therapy was achieved in 37 patients. From diagnosis to the last observation, the median HBI decreased from 7 (IQR, 5–9) to 2 (IQR, 1–2) (p<.001), the median CRP decreased from 31.4 (IQR, 16.3–48.7) mg/L to 0.7 (IQR, 0.3–2.0) mg/L(p<.001) and the median SES-CD decreased from 8 (IQR, 6–13) to 3 (IQR, 0–5) (p<.001) in the 37 patients. The results of follow-up CTE were available in 26 of the 37 patients. In the 26 patients, the median luminal diameter in the most narrowed segment increased from 2 (IQR, 1–2) mm to 5 (IQR, 4–6) mm (p < .001), the median maximum wall thickness decreased from 9 (IQR, 7–11) mm to 7 (IQR, 6–9) mm (p < .001), and the median luminal diameter in the segment proximal to the stricture decreased from 23 (IQR, 21–27) mm to 22 (IQR, 20–23) mm (p= .046).
Visual problems associated with traumatic brain injury
Published in Clinical and Experimental Optometry, 2018
A concern is whether the long‐term effects of TBI can result in neurodegenerative brain disease. In particular, CTE is a dementia believed to result specifically from repeated incidents of TBI.2013 It has been recorded in association with a variety of contact sports such as boxing, American football, hockey and wrestling2015 and has also been reported in military veterans exposed to blast shock waves from explosive devices.2013 Although controversial2013 a history of TBI appears to be the only risk factor consistently associated with CTE.2015 The clinical symptoms of CTE include impairment of memory and executive function, behavioural change and the presence of motor symptoms.2012 As a consequence, TBI may be associated with clinical symptoms, including those affecting vision, many years after a traumatic incident and can affect all aspects of professional, social and family life.
Chronic traumatic encephalopathy in sports: a historical and narrative review
Published in Developmental Neuropsychology, 2018
Omalu et al. (2011) reported that 10 of 14 (71%) of professional male athletes (ages 18–52) were positive for CTE, including 7 of 8 football players, 2 of 4 wrestlers, and 1 boxer. One of 3 high school players manifested “incipient” CTE (abnormal tau protein). The fundamental neuropathologic feature of CTE was the topographic distribution of sparse, moderate, and frequent band-shaped, flame-shaped, small and large globose neurofibrillary tangles and neuritic threads in the cerebral cortex, subcortical nuclei/basal ganglia, hippocampus, and brainstem nuclei. Hazarati et al. published the fourth study in (2013) and reported on the autopsies of 6 retired Canadian Football League players, all of whom manifest progressive neurodegeneration prior to death. Three of the six were positive for CTE, while the remaining three were diagnosed with AD, ALS, and PD. The three cases who were positive for CTE had comorbid pathology indicative of cancer, AD, and vascular disease. Hazrati et al. (2013) concluded that not athletes with a history of repetitive head trauma developed CTE.