Chronic Traumatic Encephalopathy
Chronic traumatic encephalopathy (CTE) is a degenerative brain disease typically found in individuals who have suffered repeated brain injuries. Once referred to as punch drunk syndrome, CTE remains strongly correlated with patients who have sustained concussions and repeated blows to their heads. The medical community first noticed CTE in the early 20th century because of symptoms boxers experienced. Interest in the condition has gained urgency more recently because of CTE in football players.
If you, your child, or another loved one suffered one or more brain injuries, then you may face a risk of developing CTE. Individuals who suffer brain injuries as a result of another person’s negligence may have the right to seek compensation for damages related to their injury and losses under the law. Do not delay in protecting your legal and financial rights. Contact an experienced brain injury lawyer today for a free consultation.
Below, we explore topics relating to CTE, including its causes, diagnosis, and common courses of treatment, who faces the highest risk of developing it, and how it can affect its victims and their loved ones.
CTE’s Impact on the Brain
Research on CTE has only gained steam in recent years, so it remains less well-understood than many other brain disorders. Medical professionals do know, however, that CTE develops over time in some people who have suffered traumatic brain injuries or microtrauma. In other words, doctors currently believe that CTE does not constitute an immediate symptom of brain damage. Getting a concussion today, in other words, does not make it likely for you to develop CTE tomorrow.
However, medical researchers do believe that CTE may have a relationship to post-concussive syndrome and second impact syndrome, two conditions associated with patients who have suffered repeated concussions and/or sub-concussive traumas to their brains. This emerging consensus explains the increasing alarm many medical professionals have expressed about the dangers of children, in particular, participating in sports that commonly put athletes at risks of blows or jolts to their heads, including tackle football, ice hockey, and even soccer (especially when heading a soccer ball).
Research has not yet revealed the exact mechanisms that impact the brain and lead to CTE. Most agree that repetitive injuries to the brain trigger degeneration, leading to a build-up of a protein that destroys brain cells. The presence of this protein, called tau, is a distinguishing characteristic of CTE that differentiates it from other degenerative brain conditions (such as Alzheimer’s or Parkinson’s).
Doctors have observed widely differing timeframes in which tau may accumulate to the point that a patient may begin to suffer symptoms associated with CTE, ranging from mere months to decades. Researchers continue to work to clarify the mechanisms affecting these timeframes.
Symptoms and Diagnosis of CTE
Individuals who suffer from CTE can experience these symptoms:
- Loss of memory;
- Disorientation or confusion;
- Impaired judgment;
- Difficulty controlling impulses;
- Physical and emotional aggression;
- Thoughts or attempts of self-harm or suicide; and
- Tremors, slurred speech, and slowed movement.
These symptoms mimic those commonly seen in patients suffering from other degenerative brain diseases, such as Alzheimer’s and Parkinson’s. For that reason, doctors cannot give a definitive diagnosis of CTE based upon symptoms alone. Currently, the only definitive way to diagnose CTE is to dissect a patient’s brain after the patient dies, searching for telltale signs of CTE, such as the presence of the tau protein. Researchers continue to work on developing tests for CTE in living patients based on diagnostic indicators.
For now, however, the best doctors can do for a living patient is to diagnose a probable or presumptive case of CTE, based upon the patient’s symptoms, age, lifestyle, and health history (particularly a history of repeated concussions or other head trauma).
Certain Activities Put People at a Greater Risk for CTE
Researchers currently believe that individuals whose lives put them at a heightened risk of suffering head trauma face an above-average risk of developing CTE.
Participation in Contact Sports and Activities
Athletes in contact sports risk repeated head traumas—even “minor” ones like concussions or blows that do not even result in a concussion—that could increase their chances of developing CTE. A wide array of athletic activities can involve the sort of head traumas believed to play a role in CTE development. They include boxing, martial arts, football, ice hockey, soccer, skiing, and skateboarding.
Military Service in Combat-related Roles
Active duty military members who serve in combat-related roles face a higher-than-average risk of sustaining repeated head traumas and micro-traumas, and may develop CTE at higher rates. Personnel exposed to repeated explosions and concussive blasts (such as the blast from field artillery), for example, may risk the sort of “minor”, repeated brain trauma that, over time, leads to the emergency of CTE.
Working in Heavy Industry
Similar to the risks run by soldiers in combat roles, workers in heavy industries exposed to blasting and vibration may also face risks of developing CTE. The noise and heavy equipment on construction sites can transmit sound and mechanical energy through workers’ bodies and inflict micro-trauma on the brain.
Suffering From Domestic Violence Injuries
Parents who shake crying babies can cause head injuries (shaken baby syndrome), as well as those who hit children in the head. Babies and children who suffer repeated head traumas risk developing CTE during adulthood. Similarly, abusive partners can inflict repeated concussions and subconcussive head traumas that can lead to CTE.
Currently, doctors can only treat the symptoms of CTE. There is no known cure.
CTE symptoms doctors can often treat include:
- Mood changes. If a CTE patient struggles with anxiety, depression, or aggression, doctors may refer them to a therapist who can work with the patient to develop behavioral tools and coping strategies to manage their emotions. Doctors may also prescribe a range of medications aimed at treating acute symptoms of common CTE-related mental health conditions such as depression or anxiety.
- Headaches. Repeated headaches are often associated with CTE. Some patients find relief with massage, acupuncture, pain medication, or craniosacral therapy depending on their exact headache patterns and pain levels.
- Memory issues. Doctors and therapists may help CTE patients train their memory through exercises and note-taking, which can help them get through their daily routines.
- Motor difficulties. Therapies proven effective for treating motor difficulties common of other degenerative diseases, such as Parkinson’s, may also prove effective in alleviating symptoms in CTE patients.
CTE Can Cause Financial Devastation for Victims and Their Families
As if the physical and emotional difficulties inflicted by CTE were not debilitating enough, CTE can often cause a severe economic burden for victims and their families. The costs can start piling up before a victim even knows about CTE, in the form of medical treatment for repeated head trauma, and expenses related to the fallout from various symptoms of CTE that disrupt a victim’s life.
Once presumptively diagnosed, CTE can inflict additional costs, such as:
Each head trauma or brain injury that contributes to the development of CTE varies in location and severity. Symptoms also vary among people. Once a patient communicates their symptoms and concerns to their physician, it can take weeks or months of tests to narrow the focus to the brain, let alone make a CTE diagnosis. In addition to diagnostics, CTE patients typically must undergo a battery of tests revealing their cognitive and functional shortcomings, as well as ample diagnostic imaging, including MRI and CT scans.
When a CTE patient’s doctor starts treating symptoms, the patient often begins seeing specialists who treat acute symptoms, such as cognitive struggles and loss of motor functions. For example, occupational therapists help CTE patients learn strategies to perform personal hygiene, self-care, and other regular tasks. Speech and language therapists help patients and families learn how to communicate ideas and words as the CTE worsens.
Specialist visits constitute a costly part of ongoing CTE treatment, which keeps medical bills rolling in, forcing some families to face foreclosure, file bankruptcy, or simply struggle to meet basic needs like food, shelter, and clothing.
CTE symptoms progressive worsen as time goes by because CTE is a degenerative brain disease. In the early stages, family members might be able to care for their loved ones at home. However, when the disease progresses to a certain point, partners or other family members often simply cannot provide the care their loved ones need. At the very least, a household needs respite care or full-time home nursing care. Patients who have progressed to later stages of CTE typically must live in a nursing home to receive the ongoing care they need.
Long-term nursing care facilities are typically the most costly of all aspects of medical treatment for people who suffer from CTE. Most health insurance plans do not cover nursing homes unless the patient already has a special insurance policy in place before their diagnoses. The expense of a nursing home can bankrupt some families.
In some cases, CTE patients can live at home and receive the care they need. However, families may need to make the home safer and more accessible. CTE patients who are mobile still can suffer from memory problems, disorientation, and poor judgment, making the average home dangerous in many ways.
Sometimes families need to install security systems to alert them when their loved one goes outside, for example. In other cases, families need to take steps to protect their loved one from accidental injuries. This may require putting locks on drawers and interior doors as a way to limit the patient’s access to potentially dangerous household goods, such as power tools.
A person suffering from the degenerative symptoms of CTE will eventually have to quit working because in the long run CTE, like any progressive brain illness, will impair the patient’s ability to perform job tasks. If the CTE patient brought home a substantial portion of a household’s income, the loss of the patient’s wages can devastate a family and increase its financial burden. Some CTE patients qualify for disability payments, but these typically only cover two-thirds of the patient’s average weekly salary, at most.
Losing part or all of a household’s income source poses challenges for most families. It can make paying expenses such as mortgages, car loans, insurance, and utilities difficult. Younger adults who suffer from CTE might never fully peak in their careers, which forces them to rely on their family, the government, and a wide range of other services and programs for financial and day-to-day support.
As CTE progresses, patients also lose the ability to keep up with daily activities, chores, and other life-demands. Partners or other family members may step into a caretaker role for a while, but that comes with a significant cost-benefit trade-off, and often proves unsustainable over the long-term. Frequently, families of CTE sufferers find that they cannot get by without hiring outside help to assist the CTE patient with everyday tasks, errands, and activities.
Services that may help CTE patients or victims continue living independently include:
- Lawn care, landscaping, and yard service who can help with mowing, trimming bushes, watering gardens and plants, cleaning the pool;
- A handyman who can fix minor issues in and around the house;
- Childcare, nanny, or daycare center, especially when the CTE patient was responsible for small children at home;
- A tutor to help kids with homework;
- Cleaning service to dust, vacuum, and do laundry;
- A grocery delivery service and/or cook to help with meals;
- A personal assistant to help with errands and to keep the patient’s affairs in order; and
- A driver.
Lawyers Can Help CTE Victims Secure Compensation
CTE is a serious diagnosis that has long-term physical, emotional, and financial consequences for patients and their families. CTE victims may have valuable legal rights to receive substantial compensation to help them pay for the therapies and support they need to live with their disease.
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