Chronic traumatic encephalopathy

Gross images showing a brain with chronic traumatic encephalopathy (CTE) and a normal brain. (WC/BU)

Chronic traumatic encephalopathy, abbreviated CTE, is a neurodegenerative disease due to repeated trauma.

The in the context of boxing it is known as dementia pugilistica; pugil is boxer in Latin.

General

• Due to head trauma - usually repetitive.
  • Seen in American football and boxing.
• May be associated with motor neuron disease.

Microscopic

Features:

• Wall-to-wall neurofibrillary tangles.
  • Common in olfactory bulb, mammillary bodies, hippocampus.
  • Usually perivascular around small blood vessels.
  • Often superficial (unlike Alzheimer disease) and at the deep aspect of sulci.
    • But not restricted to superficial regions of sulci (also deep in parenchyma).
  • Staging according to Bienik et al.: NFT in <5 regions: low CTE, in 5 or more: high CTE.

IHC

• Increased TDP-43 staining.
• p-Tau neuronal aggregates.
  • +/. thron shaped-astrocytes.
• Usu. absence of beta-amyloid.

Note:

• ALS associated with traumatic brain injuries.

See also

• Neurodegenerative diseases.
• Neuropathology.