Why the confusion over CTE? Because the entire issue of TBI and mTBI is not even clear in the scientific literature. Definition of terms are widely disparate and scientific study conclusions are grossly overstated. Research in this area is being published so quickly that it is hard to keep up. I typed Chronic Traumatic Encephalopathy into the pubmed.gov search engine just before starting this post and there were 655 results.
A short time line includes the papers by Martland (1928) > Corsellis (1973) > Omalu (2005)
1. CTE is a neurodegenerative disorder diagnosed upon autopsy only. It IS a REAL THING!
2. There is NO clinical diagnosis that can yet be made for CTE. The reporting of “CTE symptoms” adds greatly to the confusion for the lay public.
3. The incidence of CTE is not yet known.
4. What exactly is occurring when CTE develops (neuropathological mechanisms) is not yet known.
5. Few disagree that repeated blows to the head are problematic, i.e. lead to neuropathological changes. The issue is how that will manifest and if it will manifest for an individual. Will it lead to dementia, Alzheimer’s, Parkinson’s ALS, CTE, or nothing at all?
6. This new paper - https://www.ncbi.nlm.nih.gov/pubmed/30664683 - includes nebulous language regarding a “casual link” - “prospective studies that firmly establish the causal link between repetitive head trauma and the characteristic neuropathology of the disorder [CTE] are lacking”
Yet the next sentence says, “The frequency, severity, and total exposure to head trauma and the exact pathophysiologic mechanism by which blows to the head result in CTE are active areas of research.”
But then it says, “Exposure to head injuries is thought to be a necessary factor in developing CTE, yet head injuries in isolation are not sufficient to cause the condition, thus a search is under way to define the additional susceptibility factors that increase risk of the disease.”
So which is it?
An appropriate analogy is how many “sugar exposures” will lead to diabetes? Or will it be heart disease or fatty liver which manifests first? Bottom line, repeated sugar exposures are not good.
Our biggest concern is what are the ramifications for our kids? We are not here to tell parents how to parent. Some will allow their kids to play contact/collision/extreme sports and some will not. Some will let their kids participate without ever asking about safety or thinking that nothing will happen to their child, or worse think that they’ve “got safety covered.” Dunning-Kruger rules the day. On the opposite end of the spectrum are the parents that refuse to let their kids participate in any organized sport for fear of injuries with long term ramifications.
We are here to say that you owe it to your child to have all aspects of safety preparedness buttoned up tight. All “Ts” crossed and all “I’s” dotted. That includes things like “recess” and “class trips,” not only organized sports. That is the why behind having a safety system. All the laws, sideline providers (ATs), equipment, protocols, education may not be enough if appropriate action, documentation, communication, and oversight are not maintained in real-time and for all stakeholders.
Read about all the failures in this tragic case: Concussion Confusion in Youth Sports: A No-Brainer?
When in Doubt, Take Them Out!