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Chronic Traumatic Encephalopathy (CTE)

(Dementia Pugilistica)


The Manual's Editorial Staff

Reviewed/Revised Dec 2022
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What is chronic traumatic encephalopathy (CTE)?

Chronic traumatic encephalopathy (CTE) is the breakdown of brain cells over time. It's caused by repeated head injury or blasts from explosions. Head injuries include concussions Concussion A concussion is an injury to your brain that temporarily affects your thinking and awareness. The skull bone protects your brain. Fluid inside your skull also cushions your brain. However, if... read more .

What causes CTE?

CTE is caused by:

  • Repeated head injuries, such as from playing football, boxing, or other sports—each head injury doesn't have to be severe to cause CTE

  • Head injury from an explosion, most commonly in soldiers in combat

What are the symptoms of CTE?

Symptoms of CTE may not start until later in life, sometimes after age 60.

Some people with CTE have mild symptoms in young adulthood that get more severe later in life.

Symptoms include:

How can doctors tell if I have CTE?

Doctors suspect CTE in people who have had many episodes of head injuries or exposure to loud explosions and have symptoms of CTE.

There's no test to confirm a CTE diagnosis, but doctors will do brain imaging tests such as CT scan Computed Tomography A CT scan uses a large machine shaped like a large donut to take x-rays from many angles. A computer then takes the x-rays and creates many detailed pictures of the inside of your body. Each... read more (computed tomography). The imaging tests help doctors see if the person has some other condition with similar symptoms. The only way doctors know for sure a person has CTE is by studying the person's brain after death.

How do doctors treat CTE?

There's no cure for CTE, but the following help:

  • Living in a safe and structured environment with a routine and regular activities

  • Clearly explaining any changes in surroundings or caregivers

  • Counseling

  • Medicine to help with symptoms

To help reduce risk of CTE, people who have had a concussion should rest and stay away from athletic activities for a period of time.

Before their decision making is affected, people with CTE should make as many medical, financial, and legal decisions as possible. This includes choosing someone who can make additional medical decisions on your behalf once you can no longer do so. You should also discuss with your doctor what types of care you will want at the end of your life (living will Advance Directives Health care advance directives are legal documents that communicate a person’s wishes about health care decisions in the event the person becomes incapable of making health care decisions. There... read more ).

As CTE gets worse, treatment tends to be for comfort instead of lengthening life.

Care for caregivers

Caring for people with any type of dementia, including CTE, is stressful and demanding. Caregivers may become depressed and exhausted, often not taking care of their own mental and physical health. It's important for caregivers to:

  • Learn how to meet the needs of people with dementia and what to expect from them

  • Seek help when needed, such as from day-care programs, visits by home nurses, housekeeping help, live-in assistance, counseling, and support groups

  • Take time to care for themselves, including spending regular time with friends and on hobbies and activities

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