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DOI: 10.1055/s-0041-1732794
Uneasy Lies the Head that Wears the Crown: Historical Vignette on Chronic Traumatic Encephalopathy
Progressive neurological deterioration in boxers who suffer repeated traumatic brain injury (TBI) was termed chronic traumatic encephalopathy (CTE) by Macdonald Critchley.[1] Behavioral changes including emotional lability, slowness of speech and thought, memory deterioration, mood swings, irritability, depression, paranoia, and uninhibited violent behavior are the features of CTE.[1] The victims also have a combination of pyramidal, extrapyramidal, and cerebellar signs.[1] CTE is now increasingly documented in athletes involved in contact sports.[2] It is a neurodegenerative disorder akin to Alzheimer’s disease, with perivascular accumulation of phosphorylated tau proteins in neurons and astrocytes at the depths of the cortical sulci.[2]
Clinically, CTE is divided into four stages, based on the increasing disability of the patients ([Table 1]). CTE has gained recognition only recently, as, historically, there is sparse documentation of repetitive head injury, leading to behavioral alterations. We present two documented cases of startling personality changes and psychological decline in kings who suffered from repeated TBI.
Stage 1 |
Headaches with loss of attention and concentration |
Stage 2 |
Stage 1 features with explosiveness, short-term memory loss, mood swings and depression |
Stage 3 |
Worsening of stage 2 features with cognitive impairment, executive dysfunction and visuospatial abnormalities |
Stage 4 |
Worsening of stage 3 symptoms with dementia, paranoia, aggression, impulsivity and motor problems (Parkinsonism, gait and speech abnormalities) |
Publication History
Article published online:
29 July 2021
© 2021. Neurotrauma Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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References
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