Dr Saiz Las Cruces cteThe movie Concussion has helped highlight the potential for negative long term impacts to people who suffer from concussions. Unfortunately, we still know very little about the link between brain trauma and dementia/ CTE.

Dementia Pugilistica or Punch-Drunk Syndrome is a form of dementia usually seen with boxers. What medical people are realizing, sports with frequent head trauma (Rugby, American Football, Soccer) are also at risk of this form of dementia. The physical manifestations include headaches, dizziness, nausea, personality changes and blackouts. Recent autopsy results on Fred McNeill (Minnesota Vikings Football Player in the 70’s & 80’s) have revealed increased deposits of proteins within his brain. Mr. McNeill was diagnosed with CTE & Dementia in his elderly years and he donated his brain to science. His autopsy results showed abnormal protein deposits of Tau. Tau protein has been linked with CTE and Alzheimer’s dementia.

Concussion causes injury to the brain by causing internal bouncing of the brain within the skull (much like a pebble within a balloon). The trauma causes stretching and deformation which could injure the actual cells and their communication bundles (axons). The belief is that the injury allows nerve cells to release proteins (tau) which could initiate abnormal scarring and tangling of the nerves affecting the ability of the brain to communicate.

Concussion causes injury to the brain by causing internal bouncing of the brain within the skull (much like a pebble within a balloon)

Another mechanism thought to cause brain changes is injury to the blood-brain barrier (BBB). The BBB isolates the brain from the general bloodstream. If brain proteins leak out through the BBB, the bodies autoimmune system may see these proteins and think they are foreign. If this happens, antibodies are formed against the brain proteins. If these antibodies enter thru the damaged BBB, then there is the potential for an autoimmune attack against the brain.

As research continues and our body of information grows, people are more worried about the potential long term effects of concussion with kids. Andrew Mayer from the University of New Mexico has published a paper detailing long term brain changes in children after concussion. These changes persist even after the child has resolved the concussion symptoms. This leads to questions being asked by Parents and Coaches that include
“When is a concussion fully resolved?”
“Does a concussion predispose my child to long term dementia?”
“Should I allow my child to play contact sports?”

Ultimately, the decision to play certain sports in childhood will become a personal question that every parent has to ask themselves. Hopefully, with more information, we can make better informed decisions.

-Dr. Paul Saiz
Las Cruces, New Mexico

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