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Chronic Traumatic Encephalopathy
Surjith Vattoth, MD, FRCR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Chronic traumatic encephalopathy (CTE)
              • Synonyms

                • "Punch-drunk" syndrome/dementia pugilistica
                  • Old terms originally applied to boxer's dementia
                  • Leg weakness, vertigo, gait difficulties, episodes of confusion, later parkinsonism & dementia
              • Definitions

                • Neurodegenerative disease induced by repetitive concussive/subconcussive traumatic brain injuries (TBI)
                  • CTE classically defined secondary to repetitive TBI
                  • Postmortem studies also suggest single TBI as cause 
                • Currently diagnosis by postmortem neuropathological examination based on specific pattern of tau deposition

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Reporting Tips

                                        Selected References

                                        1. Falcon B et al: Novel tau filament fold in chronic traumatic encephalopathy encloses hydrophobic molecules. Nature. 568(7752):420-3, 2019
                                        2. Ruprecht R et al: Systematic review on the characterization of chronic traumatic encephalopathy by MRI and MRS. J Magn Reson Imaging. 49(1):212-28, 2019
                                        3. Stern RA et al: Tau positron-emission tomography in former National Football League players. N Engl J Med. 380(18):1716-25, 2019
                                        4. Sparks P et al: Neuroimaging in the diagnosis of chronic traumatic encephalopathy: a systematic review. Clin J Sport Med. ePub, 2017
                                        5. Shetty T et al: Imaging in chronic traumatic encephalopathy and traumatic brain injury. Sports Health. 8(1):26-36, 2016
                                        6. Bramlett H et al: Long-term consequences of traumatic brain injury: current status of potential mechanisms of injury and neurologic outcomes. J Neurotrauma. 32(23):1834-48, 2015
                                        7. Esopenko C et al: Aging, neurodegenerative disease and traumatic brain injury: the role of neuroimaging. J Neurotrauma. 32(4):209-20, 2015
                                        8. Stein TD et al: Beta-amyloid deposition in chronic traumatic encephalopathy. Acta Neuropathol. 130(1):21-34, 2015
                                        9. Aungst SL et al: Repeated mild traumatic brain injury causes chronic neuroinflammation, changes in hippocampal synaptic plasticity, and associated cognitive deficits. J Cereb Blood Flow Metab. 34(7):1223-32, 2014
                                        10. Gandy S et al: Chronic traumatic encephalopathy: clinical-biomarker correlations and current concepts in pathogenesis. Mol Neurodegener. 9:37, 2014
                                        11. Saigal R et al: The long-term effects of repetitive mild head injuries in sports. Neurosurgery. 75 Suppl 4:S149-55, 2014
                                        12. Sundman MH et al: Examining the relationship between head trauma and neurodegenerative disease: a review of epidemiology, pathology and neuroimaging techniques. J Alzheimers Dis Parkinsonism. 4, 2014
                                        13. Johnson VE et al: Widespread τ and amyloid-β pathology many years after a single traumatic brain injury in humans. Brain Pathol. 22(2):142-9, 2012
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Chronic traumatic encephalopathy (CTE)
                                                    • Synonyms

                                                      • "Punch-drunk" syndrome/dementia pugilistica
                                                        • Old terms originally applied to boxer's dementia
                                                        • Leg weakness, vertigo, gait difficulties, episodes of confusion, later parkinsonism & dementia
                                                    • Definitions

                                                      • Neurodegenerative disease induced by repetitive concussive/subconcussive traumatic brain injuries (TBI)
                                                        • CTE classically defined secondary to repetitive TBI
                                                        • Postmortem studies also suggest single TBI as cause 
                                                      • Currently diagnosis by postmortem neuropathological examination based on specific pattern of tau deposition

                                                    IMAGING

                                                    • General Features

                                                      • CT Findings

                                                        • MR Findings

                                                          • Nuclear Medicine Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Staging, Grading, & Classification

                                                                    • Gross Pathologic & Surgical Features

                                                                      • Microscopic Features

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Reporting Tips

                                                                              Selected References

                                                                              1. Falcon B et al: Novel tau filament fold in chronic traumatic encephalopathy encloses hydrophobic molecules. Nature. 568(7752):420-3, 2019
                                                                              2. Ruprecht R et al: Systematic review on the characterization of chronic traumatic encephalopathy by MRI and MRS. J Magn Reson Imaging. 49(1):212-28, 2019
                                                                              3. Stern RA et al: Tau positron-emission tomography in former National Football League players. N Engl J Med. 380(18):1716-25, 2019
                                                                              4. Sparks P et al: Neuroimaging in the diagnosis of chronic traumatic encephalopathy: a systematic review. Clin J Sport Med. ePub, 2017
                                                                              5. Shetty T et al: Imaging in chronic traumatic encephalopathy and traumatic brain injury. Sports Health. 8(1):26-36, 2016
                                                                              6. Bramlett H et al: Long-term consequences of traumatic brain injury: current status of potential mechanisms of injury and neurologic outcomes. J Neurotrauma. 32(23):1834-48, 2015
                                                                              7. Esopenko C et al: Aging, neurodegenerative disease and traumatic brain injury: the role of neuroimaging. J Neurotrauma. 32(4):209-20, 2015
                                                                              8. Stein TD et al: Beta-amyloid deposition in chronic traumatic encephalopathy. Acta Neuropathol. 130(1):21-34, 2015
                                                                              9. Aungst SL et al: Repeated mild traumatic brain injury causes chronic neuroinflammation, changes in hippocampal synaptic plasticity, and associated cognitive deficits. J Cereb Blood Flow Metab. 34(7):1223-32, 2014
                                                                              10. Gandy S et al: Chronic traumatic encephalopathy: clinical-biomarker correlations and current concepts in pathogenesis. Mol Neurodegener. 9:37, 2014
                                                                              11. Saigal R et al: The long-term effects of repetitive mild head injuries in sports. Neurosurgery. 75 Suppl 4:S149-55, 2014
                                                                              12. Sundman MH et al: Examining the relationship between head trauma and neurodegenerative disease: a review of epidemiology, pathology and neuroimaging techniques. J Alzheimers Dis Parkinsonism. 4, 2014
                                                                              13. Johnson VE et al: Widespread τ and amyloid-β pathology many years after a single traumatic brain injury in humans. Brain Pathol. 22(2):142-9, 2012