An all-inclusive guide for athletes suffering from CTE after experiencing multiple concussions
Recently, there’s been an increased awareness of the risks of chronic brain injuries incurred by athletes who play contact sports. This awareness has been fostered significantly by research by Boston University and others focused on concussions and chronic traumatic encephalopathy (CTE).
Their research has confirmed the linkage between CTE and multiple concussions commonly experienced by professional football players whose careers extend over many years.
What is CTE?
Chronic traumatic encephalopathy (CTE) is a degenerative form of traumatic brain injury (TBI). Unlike most TBIs, CTE develops over time and after repetitive trauma events.
CTE is a neuropsychiatric disorder that was first identified in 1928 by pathologist Harrison Martland in the course of a routine autopsy. It was linked to a condition common among boxers called “punch-drunk syndrome.”
Since then, it’s been determined that the risk of developing this condition is increased by sustained brain injury and trauma. Multiple concussions are typically suffered by boxers and other athletes who play contact sports (particularly football players) from repeated blows to the head. Also, military veterans have a greater than normal risk of CTE because of their proximity to concussive events.
The neuropathological process leading to CTE is complex. Repeated blows to the head set off a chemical response in the brain that causes a protein called “tau” to malfunction. That malfunctioning protein slowly spreads throughout the brain, forming neurofibrillary tangles and killing brain cells along the way.
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What happens with a concussion?
A concussion is a traumatic brain injury (TBI) that results from a blow to the head or body that makes the head move back and forth quickly, causing the brain to smash against the walls inside the skull.
This trauma sets off chemical changes in the brain leading to a malfunctioning protein, which, in its normal state, is essential for a healthy brain.
It should be noted that even the most advanced helmet technology will not completely eliminate the risk of concussion injuries. A blow to the head protected by a helmet does not stop the brain from banging around inside the skull, which ultimately causes brain trauma.
How is CTE diagnosed?
Unfortunately, CTE cannot be diagnosed while a person is alive. The tau tangles can only be seen microscopically in stained brain samples during an autopsy.
Boston University is renowned for its definitive research on CTE. Numerous deceased NFL players who suffered from apparent CTE symptoms have donated their brains to the university for analysis.
Although CTE cannot be confirmed before death, a presumptive diagnosis can be based on symptoms and neurological exams. Also, a patient’s history of head injuries provides evidence. Lab and imaging tests will not diagnose CTE, but some can rule out other causes of CTE symptoms.
What are the symptoms of CTE?
According to Mayo Clinic, no specific symptoms have been inextricably linked to CTE. Some of the symptoms are also symptoms of other conditions. Among those cases of proven CTE, the main symptoms have included cognitive, behavioral, mood and motor changes.
Mood disorders include:
- Depression
- Emotional instability
- Substance abuse
- Suicidal thoughts or actions
Cognitive impairment includes:
- Thinking difficulty
- Memory loss
- Difficulty with planning, organizing and carrying out tasks
Behavioral changes include:
- Impulsive conduct
- Aggressive behavior
Motor symptoms include:
- Parkinson’s disease
- Motor neuron disease
CTE usually takes years to develop after multiple concussions or head trauma. When it does develop, it takes different forms depending on the subject’s age:
- Between the late 20s and early 30s, CTE may cause mental health and behavioral patterns, including depression, anxiety, impulsivity and aggression.
- After 60, the symptoms are more likely to include memory and thinking problems that might develop into dementia.
Is there treatment for CTE?
There is no cure for CTE once it has progressed. The best treatment is simply to avoid further trauma. Repetitive concussions increase the risk and/or development of CTE with each repeated traumatic event.
Abnormalities continue to be seen up to 5 weeks after a concussion. Therefore, at least a month may be required before safely returning to play. An earlier return poses an increased likelihood of a repeat concussion.
Georgia workers’ compensation benefits
All states have a workers’ compensation system that compensates workers injured on the job. It’s important to note that only employees are covered—independent contractors are not.
Workers’ compensation benefits include the following:
- Payment for medical care
- Payment of two-thirds of the worker’s average wages for a duration depending on the extent of their disability
- Death benefits
There are special issues relating to CTE. Georgia’s system, like other states, covers employees who suffer injury or illness occurring while they’re performing their assigned duties.
We know that CTE is often caused by repetitive concussions or other brain trauma. We also know that CTE cannot be confirmed until the subject dies, so linking CTE to an on-the-job event can be difficult.
Furthermore, workers’ comp only covers employees. Many athletes are not professional athletes but amateurs who are considered independent contractors and are not eligible for workers’ comp benefits.
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The NFL’s response to CTE
In 2013, the NFL settled a lawsuit by former NFL players who suffered repetitive concussions for $750,000. The plaintiffs included the family of Junior Seau, who suffered several CTE symptoms before committing suicide. His autopsy showed evidence of CTE.
The NFL has also responded with more stringent protocols for dealing with concussions.
Post-concussion syndrome (PCS) and chronic traumatic encephalopathy (CTE) in athletes
Post-concussion syndrome (PCS) is a complex disorder that continues to present symptoms long after a concussion or mild traumatic brain injury (TBI) has occurred.
Athletes, particularly those in high-contact sports such as football, hockey and boxing, are at a significant risk of developing PCS due to the repeated blows and impacts they endure during training and competitions.
Symptoms of PCS in athletes can include headaches, dizziness, cognitive impairments and emotional instability. These symptoms can seriously hinder an athlete’s performance, overall well-being, and quality of life.
Connection to chronic traumatic encephalopathy (CTE)
Chronic traumatic encephalopathy (CTE) is a progressive degenerative disease found in individuals who have sustained multiple concussions or TBIs.
The condition is most commonly associated with athletes in contact sports, but it can also affect military veterans and others exposed to repeated head trauma.
CTE presents with many symptoms similar to those of PCS, such as memory loss, confusion and emotional disturbances. However, CTE tends to progress more severely, leading to more debilitating conditions like dementia.
The critical link between PCS and CTE
The critical link between PCS and CTE lies in repeated traumatic injuries to the brain.
While PCS can occur after a single concussion, the risk of developing both PCS and, later, CTE increases with multiple injuries. In the world of professional sports, where head impacts can be a routine part of the game, understanding this connection is vital.
Prevention, care and awareness
The best way to reduce the cases of PCS and CTE in athletes and minimize their long-term effects is through the following:
- Education. Athletes, coaches and medical staff must be well-informed about the symptoms, risks and long-term effects of both PCS and CTE.
- Early intervention. Prompt diagnosis and appropriate treatment of concussions can reduce the risk of developing PCS and potentially CTE.
- Regular monitoring. Ongoing monitoring and assessments can help detect early signs of these conditions, allowing for timely intervention.
Athletes, like any other workers, face the risk of injuries on the job, including serious head injuries that can lead to conditions like PCS and CTE.
These injuries might seem like an inherent part of their high-paying profession, but it’s essential to remember that health is the ultimate wealth.
No amount of money can fully restore health once it’s gone. If you’re an injured athlete, know that you have rights, including access to workers’ compensation, to assist in recovery or provide for your family in fatal cases.
Don’t let your profession dictate your well-being; reach out to us today to learn more about your legal options and protect your most valuable asset—your health.
Contact a Georgia workers’ compensation attorney
The recent heightened awareness of the long-term suffering from head injuries is necessary for improved safety for athletes. Hopefully, amateur athletic programs in colleges and high schools will follow suit.
Those who are reading this are encouraged to learn more about CTE and pressure their local high schools to adopt protocols for protecting their youth.
If you’re an athlete or other worker who believes you’re suffering from symptoms of CTE or any other work-related injury or illness, contact the experienced workers’ compensation attorneys at Gerber & Holder Workers’ Compensation Attorneys. We have over 75 years of combined experience helping injured workers across Georgia recover compensation after an injury.
