Chronic traumatic encephalopathy

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

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

The in the context of boxing it is known as dementia pugilistica; pugil is boxer in Latin.[1]


  • Due to head trauma - usually repetitive.
    • Seen in American football and boxing.
  • May be associated with motor neuron disease.[2]



  • 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.[4]


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


  • ALS associated with traumatic brain injuries.[5]

See also


  1. URL: Accessed on: 21 November 2011.
  2. Daneshvar, DH.; Riley, DO.; Nowinski, CJ.; McKee, AC.; Stern, RA.; Cantu, RC. (Nov 2011). "Long-term consequences: effects on normal development profile after concussion.". Phys Med Rehabil Clin N Am 22 (4): 683-700. doi:10.1016/j.pmr.2011.08.009. PMID 22050943.
  3. Stern, RA.; Riley, DO.; Daneshvar, DH.; Nowinski, CJ.; Cantu, RC.; McKee, AC. (Oct 2011). "Long-term Consequences of Repetitive Brain Trauma: Chronic Traumatic Encephalopathy.". PM R 3 (10 Suppl 2): S460-7. doi:10.1016/j.pmrj.2011.08.008. PMID 22035690.
  4. "Intrauterine growth retardation and fetal transverse cerebellar diameter". Prenat Diagn 14 (12): 1101–5. December 1994. doi:10.1002/pd.1970141202. PMID 7899277.
  5. Costanza, A.; Weber, K.; Gandy, S.; Bouras, C.; Hof, PR.; Giannakopoulos, P.; Canuto, A. (Oct 2011). "Review: Contact sport-related chronic traumatic encephalopathy in the elderly: clinical expression and structural substrates.". Neuropathol Appl Neurobiol 37 (6): 570-84. doi:10.1111/j.1365-2990.2011.01186.x. PMID 21696410.