Chronic traumatic encephalopathy (CTE) in a National Football League Player: Case report and emerging medicolegal practice questions.
Chronic traumatic encephalopathy (CTE) in a National Football League Player: Case report and emerging medicolegal practice questions.
复制标题
DOI：
10.1111/j.1939-3938.2009.01064.x
复制
发表时间：
2010-01-01
影响因子：
1
通讯作者：
Bailes, Julian
中科院分区：
文献类型：
--
作者：
Omalu, Bennet I;Hamilton, Ronald L;Bailes, Julian
未标记：我们报告了一例慢性创伤性脑病(CTE)的退役国家橄榄球联盟(NFL)球员的尸检结果，载脂蛋白E基因型别和脑组织证据的慢性脑损伤。这位44岁的退役NFL球员在死前表现出认知和神经精神障碍的病史，部分包括慢性抑郁症、自杀未遂、失眠、偏执和记忆受损，最后自杀。对他的血液进行了基于聚合酶链式反应的全面尸检，以确定载脂蛋白基因。用组织化学和免疫组织化学方法对脑局部大体切片进行分析。尸检证实头部有致命枪伤。载脂蛋白E基因为E3/E3，脑组织表现为弥漫性脑张力性病变(神经原纤维缠结和神经丝)。这将是第三例国家足球运动员的CTE病例，医学文献中已经报道了这种情况。OMalu等人在2005年和2006年报告了头两个病例。这一系列的病例表现出类似的神经精神损害的死亡前病史，尸检证据显示没有任何神经炎性淀粉样变性的脑拉伸症。为了做出CTE的明确诊断，以及出于法医学的目的，必须进行全面的尸检，并对大脑进行组织化学和免疫组织化学分析，以确定是否存在神经原纤维缠结(NFTs)和神经性线条(NTS)。
UNLABELLED: We present a case of chronic traumatic encephalopathy (CTE) in a retired National Football League (NFL) Player with autopsy findings, apolipoprotein E genotype, and brain tissue evidence of chronic brain damage. This 44-year-old retired NFL player manifested a premortem history of cognitive and neuropsychiatric impairment, which included in part, chronic depression, suicide attempts, insomnia, paranoia, and impaired memory before he finally committed suicide. A full autopsy was performed with Polymerase Chain Reaction-based analyses of his blood to determine the apolipoprotein genotype. Histochemical and immunohistochemical analyses were performed on topographical gross sections of the brain. Autopsy confirmed a fatal gunshot wound of the head. The apolipoprotein E genotype was E3/E3 and the brain tissue revealed diffuse cerebral taupathy (Neurofibrillary Tangles and Neuritic Threads). This will be the third case of CTE in a national football player, which has been reported in the medical literature. Omalu et al., reported the first two cases in 2005 and 2006. This case series manifested similar premortem history of neuropsychiatric impairment with autopsy evidence of cerebral taupathy without any neuritic amyloidopathy. For a definitive diagnosis of CTE to be made, and for medicolegal purposes, a full autopsy must be performed with histochemical and immunohistochemical analyses of the brain to identify the presence of Neurofibrillary Tangles (NFTs) and Neuritic Threads (NTs).IMPLICATIONS: Further longitudinal prospective studies are required to confirm the common denominators and epidemiology of CTE in professional American football players, which have been identified by this case series.