Difference between revisions of "Chronic traumatic encephalopathy"

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(External links: included authors of article of immediately preceding edit - Medical Author: Benjamin Wedro, MD, FACEP, FAAEM, Medical Editor: Melissa Conrad Stöppler, MD)
(addn info - external link - symptoms immediate and long-term residual - can tragically be confused with demonic possession)
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'''Chronic traumatic encephalopathy''' is a disease of the human [[brain]].  It is caused by repeated blows or injury to the brain over time.  Diagnosis is confirmed by an autopsy examination of the brain after death.  There is no known cure, but available data suggests that the disease can be avoided by avoiding and minimizing brain trauma.  The disease was previously called ''dementia pugilistica'' because it was the diagnosis given to punch-drunk boxers.
+
'''Chronic traumatic encephalopathy (CTE)''', also called '''Repetitive Traumatic Brain Injury (TBI)''' is a disease of the human [[brain]].  It is caused by repeated blows or injury to the brain over time.  Diagnosis is confirmed by an autopsy examination of the brain after death.  There is no known cure, but available data suggests that the disease can be avoided by avoiding and minimizing brain trauma.  The disease was previously called ''dementia pugilistica'' because it was the diagnosis given to punch-drunk boxers whose behavior and speech resembled drunken intoxication.
  
 
Chronic traumatic encephalopathy has been diagnosed in athletes who have participated in [[boxing]] and [[football]].  Recently, there are reports of CTE in athletes who play [[baseball]], [[rugby]] and even [[soccer]] players who repeatedly "head" the ball.<ref>{{cite news|url=https://www.nytimes.com/2014/02/27/sports/soccer/researchers-find-brain-trauma-disease-in-a-soccer-player.html?action=click&contentCollection=U.S.&module=MostEmailed&version=Full&region=Marginalia&src=me&pgtype=article|title=Brain Trauma Extends to the Soccer Field|first=John|last=Branch|date=Feb. 26, 2014|work=New York Times|accessdate=Accessed February 28, 2014}}</ref> Between 2008 and 2010, the bodies of twelve former professional [[NFL]] football players underwent postmortem evaluations for CTE, and all of them showed evidence of the disease, indicating a conservatively estimated prevalence rate of 3.7% among professional football players if no other players who died during this period had CTE.<ref>Gavett, B. E.; Stern, R. A.; McKee, A. C. (2011). "Chronic Traumatic Encephalopathy: A Potential Late Effect of Sport-Related Concussive and Subconcussive Head Trauma". Clinics in Sports Medicine 30 (1): 179–188, xi. doi:10.1016/j.csm.2010.09.007. PMC 2995699. PMID 21074091.</ref> As of December 2012, thirty-three former NFL players have been diagnosed [[post-mortem]] with CTE, including former [[Detroit Lions]] lineman and eight-time Pro Bowler [[Lou Creekmur]],<ref>[http://www.bu.edu/cste/case-studies/lou-creekmur/ Case Study: Lou Creekmur], Center for the Study of Traumatic Encephalopathy. Accessed Accessed February 28, 2014.</ref> former [[Tennessee Titans|Houston Oilers]] and [[Miami Dolphins]] linebacker [[John Grimsley]],<ref>[http://www.bu.edu/cste/case-studies/john-grimsley/ Case Study: John Grimsley], Center for the Study of Traumatic Encephalopathy. Accessed Accessed February 28, 2014.</ref> and former [[Tampa Bay Buccaneers]] guard [[Tom McHale (American football)|Tom McHale]].<ref>[http://www.bu.edu/cste/case-studies/thomas-mchale/ Case Study: Thomas McHale], Center for the Study of Traumatic Encephalopathy. Accessed February 28, 2014.</ref> An early player to be diagnosed with CTE in 2002 was Mike Webster of the Steelers.<ref>{{cite news|url=http://www.behindthesteelcurtain.com/2013/10/8/4814434/concussion-suit-mike-webster-thing|title=Webster autopsy 'one of the most significant moments in the history of sports'|date= Oct 8, 2013|accessdate=January 6, 2017}}</ref>
 
Chronic traumatic encephalopathy has been diagnosed in athletes who have participated in [[boxing]] and [[football]].  Recently, there are reports of CTE in athletes who play [[baseball]], [[rugby]] and even [[soccer]] players who repeatedly "head" the ball.<ref>{{cite news|url=https://www.nytimes.com/2014/02/27/sports/soccer/researchers-find-brain-trauma-disease-in-a-soccer-player.html?action=click&contentCollection=U.S.&module=MostEmailed&version=Full&region=Marginalia&src=me&pgtype=article|title=Brain Trauma Extends to the Soccer Field|first=John|last=Branch|date=Feb. 26, 2014|work=New York Times|accessdate=Accessed February 28, 2014}}</ref> Between 2008 and 2010, the bodies of twelve former professional [[NFL]] football players underwent postmortem evaluations for CTE, and all of them showed evidence of the disease, indicating a conservatively estimated prevalence rate of 3.7% among professional football players if no other players who died during this period had CTE.<ref>Gavett, B. E.; Stern, R. A.; McKee, A. C. (2011). "Chronic Traumatic Encephalopathy: A Potential Late Effect of Sport-Related Concussive and Subconcussive Head Trauma". Clinics in Sports Medicine 30 (1): 179–188, xi. doi:10.1016/j.csm.2010.09.007. PMC 2995699. PMID 21074091.</ref> As of December 2012, thirty-three former NFL players have been diagnosed [[post-mortem]] with CTE, including former [[Detroit Lions]] lineman and eight-time Pro Bowler [[Lou Creekmur]],<ref>[http://www.bu.edu/cste/case-studies/lou-creekmur/ Case Study: Lou Creekmur], Center for the Study of Traumatic Encephalopathy. Accessed Accessed February 28, 2014.</ref> former [[Tennessee Titans|Houston Oilers]] and [[Miami Dolphins]] linebacker [[John Grimsley]],<ref>[http://www.bu.edu/cste/case-studies/john-grimsley/ Case Study: John Grimsley], Center for the Study of Traumatic Encephalopathy. Accessed Accessed February 28, 2014.</ref> and former [[Tampa Bay Buccaneers]] guard [[Tom McHale (American football)|Tom McHale]].<ref>[http://www.bu.edu/cste/case-studies/thomas-mchale/ Case Study: Thomas McHale], Center for the Study of Traumatic Encephalopathy. Accessed February 28, 2014.</ref> An early player to be diagnosed with CTE in 2002 was Mike Webster of the Steelers.<ref>{{cite news|url=http://www.behindthesteelcurtain.com/2013/10/8/4814434/concussion-suit-mike-webster-thing|title=Webster autopsy 'one of the most significant moments in the history of sports'|date= Oct 8, 2013|accessdate=January 6, 2017}}</ref>
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Evidence of CTE was found in the autopsy of an 18-year-old high school football player.<ref>{{cite web|url=http://www.bu.edu/cte/our-research/case-studies/18-year-old/|title=18 year old high school football player|work=Boston University CTE Center|accessdate=January 6, 2017}}</ref>
 
Evidence of CTE was found in the autopsy of an 18-year-old high school football player.<ref>{{cite web|url=http://www.bu.edu/cte/our-research/case-studies/18-year-old/|title=18 year old high school football player|work=Boston University CTE Center|accessdate=January 6, 2017}}</ref>
  
The autopsy of at least one [[mixed martial arts]] fighter, Jordan Parsons, found CTE.<ref>{{cite news|url=http://www.sherdog.com/news/news/Jordan-Parsons-Posthumously-Diagnosed-with-CTE-112645|title=Jordan Parsons Posthumously Diagnosed with CTE|date=October 21, 2016|accessdate=October 31, 2016}}</ref>
+
The autopsy of at least one [[mixed martial arts]] fighter, Jordan Parsons, found signs of CTE.<ref>{{cite news|url=http://www.sherdog.com/news/news/Jordan-Parsons-Posthumously-Diagnosed-with-CTE-112645|title=Jordan Parsons Posthumously Diagnosed with CTE|date=October 21, 2016|accessdate=October 31, 2016}}</ref>
 +
 
 +
Signs and symptoms of CTE have been mistaken for evidence of demonic possession, with tragic consequences.
 +
 
 +
=== Signs and Symptoms of CTE/TBI===
 +
;Immediate danger signs
 +
:headache that gets worse and does not go away
 +
:weakness, numbness or decreased coordination
 +
:repeated vomiting or nausea
 +
:slurred speech
 +
:disturbed vision
 +
:very drowsy appearance, or cannot wake up
 +
:pupil of one eye is larger than the other
 +
:convulsions or seizures
 +
:cannot recognize people or places
 +
:increasing confusion, restless or agitated
 +
:unusual behavior
 +
:loss of consciousness
 +
;Symptoms
 +
Symptoms of TBI usually fall into four categories
 +
:Thinking/Remembering
 +
::difficulty thinking clearly
 +
::feeling slowed down
 +
::difficulty concentrating
 +
::difficulty remembering new information
 +
:Physical
 +
::headache
 +
::fuzzy or blurry vision
 +
::nausea early on, soon after trauma to the head
 +
::dizziness
 +
::sensitivity to noise or light
 +
::balance problems
 +
::fatigue, feeling tired, having no energy
 +
:Emotional/Mood
 +
::irritability
 +
::sadness
 +
::much more emotional, sensitive, moody
 +
::nervousness or anxiety
 +
:Sleep
 +
::sleeping more than usual
 +
::sleeping less than usual
 +
::trouble falling asleep
 +
===Progression===
 +
Early symptoms include a decline of [[memory]] and [[Rational behavior|executive (decision) functioning]], [[depression]], suicidal ideation (thoughts of [[suicide]]) and/or behavior (attempts to commit suicide), and poor [[impulse]] control. Symptoms may begin years or decades after cessation of brain trauma exposure although onset is earlier than most other neurodegenerative diseases. Disease progress is slow and eventually leads to [[dementia]]. In some individuals, CTE may lead to a motor neuron disease, similar to [[ALS]].
 +
===CTE/TBI and demonic possession===
 +
The signs and symptoms of chronic traumatic encephalopathy have been tragically mistaken for signs of [[Possession|demonic possession]]. Some innocent persons suffering from the effects of CTE including children and young teens and others with [[PTSD]] and relatively defenseless elderly persons in their sixties and seventies suffering from dementia resulting from CTE, have been targeted by ignorant individuals as being victims of possession by evil spirits or the [[Devil]], because the signs and symptoms of their speech and/or behavior due to CTE are misinterpreted as evidence of evil presences. They are accused of being possessed, often being held down and "prayed over", and then restrained and bound tightly (sometimes even subjected to involuntary confinement for hours, days, weeks, even months) and repeatedly subjected to the ritualistic torments of prolonged, barbaric amateur "[[exorcism]]s" resulting in permanent mental, emotional, painful, and bloody physical injuries, even death. These vicious "exorcists", sometimes themselves the misguided spouses and parents and adult children of the victims, when apprehended have been charged, tried, and either found to be mentally ill, or guilty of murder and sentenced to imprisonment or execution for committing a heinous crime.
 +
===Important health issue===
 +
Given the millions of athletes participating in contact sports that necessarily involve repetitive brain trauma, and the military troops exposed to repetitive brain trauma from explosive blasts and other blunt-force injuries, and others in society (workers) who experience repetitive head injuries, CTE represents an important health issue<ref>Stern, et al, PM & R 2011;3:S460-S467 Conclusion p. S466</ref>.
 
==References==
 
==References==
 
<references/>
 
<references/>
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*[https://www.pbs.org/wgbh/frontline/film/league-of-denial/ League of Denial: The NFL's Concussion Crisis ''Frontline'' Documentary]
 
*[https://www.pbs.org/wgbh/frontline/film/league-of-denial/ League of Denial: The NFL's Concussion Crisis ''Frontline'' Documentary]
 
*[https://www.emedicinehealth.com/head_injury/article_em.htm Head Injury (Traumatic Brain Injury) Medical Author: Benjamin Wedro, MD, FACEP, FAAEM, Medical Editor: Melissa Conrad Stöppler, MD (emedicinehealth.com)]
 
*[https://www.emedicinehealth.com/head_injury/article_em.htm Head Injury (Traumatic Brain Injury) Medical Author: Benjamin Wedro, MD, FACEP, FAAEM, Medical Editor: Melissa Conrad Stöppler, MD (emedicinehealth.com)]
 +
*[https://www.bu.edu/cte/files/2011/11/Stern-et-al-2011-PMR-Long-term-Consequences-of-Repetitive-Brain-Trauma1.pdf PM & R, Concussion Supplement. Long-term Consequences of Repetitive Brain Trauma: Chronic Traumatic Encephalopathy, Robert A. Stern, PhD, David O. Riley, BS, David H. Daneshvar, MA, Christopher J. Nowinski, BA, Robert C. Contu, MD, Ann C. McKee, MD. PM & R, Vol. 3. Iss. 10S2, 2011, pp. S460-S467]
  
 
[[Category:Diseases]]
 
[[Category:Diseases]]
 
[[Category:Sports]]
 
[[Category:Sports]]

Revision as of 05:10, May 23, 2019

Chronic traumatic encephalopathy (CTE), also called Repetitive Traumatic Brain Injury (TBI) is a disease of the human brain. It is caused by repeated blows or injury to the brain over time. Diagnosis is confirmed by an autopsy examination of the brain after death. There is no known cure, but available data suggests that the disease can be avoided by avoiding and minimizing brain trauma. The disease was previously called dementia pugilistica because it was the diagnosis given to punch-drunk boxers whose behavior and speech resembled drunken intoxication.

Chronic traumatic encephalopathy has been diagnosed in athletes who have participated in boxing and football. Recently, there are reports of CTE in athletes who play baseball, rugby and even soccer players who repeatedly "head" the ball.[1] Between 2008 and 2010, the bodies of twelve former professional NFL football players underwent postmortem evaluations for CTE, and all of them showed evidence of the disease, indicating a conservatively estimated prevalence rate of 3.7% among professional football players if no other players who died during this period had CTE.[2] As of December 2012, thirty-three former NFL players have been diagnosed post-mortem with CTE, including former Detroit Lions lineman and eight-time Pro Bowler Lou Creekmur,[3] former Houston Oilers and Miami Dolphins linebacker John Grimsley,[4] and former Tampa Bay Buccaneers guard Tom McHale.[5] An early player to be diagnosed with CTE in 2002 was Mike Webster of the Steelers.[6]

Evidence of CTE was found in the autopsy of an 18-year-old high school football player.[7]

The autopsy of at least one mixed martial arts fighter, Jordan Parsons, found signs of CTE.[8]

Signs and symptoms of CTE have been mistaken for evidence of demonic possession, with tragic consequences.

Signs and Symptoms of CTE/TBI

Immediate danger signs
headache that gets worse and does not go away
weakness, numbness or decreased coordination
repeated vomiting or nausea
slurred speech
disturbed vision
very drowsy appearance, or cannot wake up
pupil of one eye is larger than the other
convulsions or seizures
cannot recognize people or places
increasing confusion, restless or agitated
unusual behavior
loss of consciousness
Symptoms

Symptoms of TBI usually fall into four categories

Thinking/Remembering
difficulty thinking clearly
feeling slowed down
difficulty concentrating
difficulty remembering new information
Physical
headache
fuzzy or blurry vision
nausea early on, soon after trauma to the head
dizziness
sensitivity to noise or light
balance problems
fatigue, feeling tired, having no energy
Emotional/Mood
irritability
sadness
much more emotional, sensitive, moody
nervousness or anxiety
Sleep
sleeping more than usual
sleeping less than usual
trouble falling asleep

Progression

Early symptoms include a decline of memory and executive (decision) functioning, depression, suicidal ideation (thoughts of suicide) and/or behavior (attempts to commit suicide), and poor impulse control. Symptoms may begin years or decades after cessation of brain trauma exposure although onset is earlier than most other neurodegenerative diseases. Disease progress is slow and eventually leads to dementia. In some individuals, CTE may lead to a motor neuron disease, similar to ALS.

CTE/TBI and demonic possession

The signs and symptoms of chronic traumatic encephalopathy have been tragically mistaken for signs of demonic possession. Some innocent persons suffering from the effects of CTE including children and young teens and others with PTSD and relatively defenseless elderly persons in their sixties and seventies suffering from dementia resulting from CTE, have been targeted by ignorant individuals as being victims of possession by evil spirits or the Devil, because the signs and symptoms of their speech and/or behavior due to CTE are misinterpreted as evidence of evil presences. They are accused of being possessed, often being held down and "prayed over", and then restrained and bound tightly (sometimes even subjected to involuntary confinement for hours, days, weeks, even months) and repeatedly subjected to the ritualistic torments of prolonged, barbaric amateur "exorcisms" resulting in permanent mental, emotional, painful, and bloody physical injuries, even death. These vicious "exorcists", sometimes themselves the misguided spouses and parents and adult children of the victims, when apprehended have been charged, tried, and either found to be mentally ill, or guilty of murder and sentenced to imprisonment or execution for committing a heinous crime.

Important health issue

Given the millions of athletes participating in contact sports that necessarily involve repetitive brain trauma, and the military troops exposed to repetitive brain trauma from explosive blasts and other blunt-force injuries, and others in society (workers) who experience repetitive head injuries, CTE represents an important health issue[9].

References

  1. Branch, John. "Brain Trauma Extends to the Soccer Field", New York Times, Feb. 26, 2014. Retrieved on Accessed February 28, 2014. 
  2. Gavett, B. E.; Stern, R. A.; McKee, A. C. (2011). "Chronic Traumatic Encephalopathy: A Potential Late Effect of Sport-Related Concussive and Subconcussive Head Trauma". Clinics in Sports Medicine 30 (1): 179–188, xi. doi:10.1016/j.csm.2010.09.007. PMC 2995699. PMID 21074091.
  3. Case Study: Lou Creekmur, Center for the Study of Traumatic Encephalopathy. Accessed Accessed February 28, 2014.
  4. Case Study: John Grimsley, Center for the Study of Traumatic Encephalopathy. Accessed Accessed February 28, 2014.
  5. Case Study: Thomas McHale, Center for the Study of Traumatic Encephalopathy. Accessed February 28, 2014.
  6. "Webster autopsy 'one of the most significant moments in the history of sports'", Oct 8, 2013. Retrieved on January 6, 2017. 
  7. 18 year old high school football player. Boston University CTE Center. Retrieved on January 6, 2017.
  8. "Jordan Parsons Posthumously Diagnosed with CTE", October 21, 2016. Retrieved on October 31, 2016. 
  9. Stern, et al, PM & R 2011;3:S460-S467 Conclusion p. S466

External links