Chronic traumatic encephalopathy (CTE)
Chronic traumatic encephalopathy is progressive brain damage linked to repeated blows to the head over many years.
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Medicines commonly prescribed for Chronic traumatic encephalopathy (CTE)
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: TABLET, 2 mgActive substance: risperidoneManufacturer: Laboratorios Cinfa S.A.Prescription requiredDosage form: CAPSULE, 30 mgActive substance: duloxetineManufacturer: Eli Lilly Nederland B.V.Prescription requiredDosage form: TABLET, 20 mgActive substance: memantineManufacturer: Mabo Farma S.A.Prescription required
Chronic traumatic encephalopathy is progressive brain damage linked to repeated blows to the head over many years. The most important thing about it is that it does not develop from a single severe concussion but from the accumulation of multiple, often "minor" impacts after which the person did not even lose consciousness. A definitive diagnosis can still only be made after death, by examining brain tissue — which is why the main practical topic here is prevention.
Who is at risk
- boxers, mixed martial artists, kickboxers;
- American football, rugby and ice hockey players;
- footballers, through regular heading;
- military personnel exposed to blast waves;
- people who have experienced repeated domestic violence involving blows to the head;
- people with repeated concussions, particularly if they returned to activity before recovering.
The key factor is not the force of any individual blow but their total number and the years of exposure.
Symptoms
They appear not immediately but years and even decades after the end of a career or the exposure, and build up gradually.
Behaviour and mood — usually first
- irritability, outbursts of aggression;
- impulsivity, poorly considered decisions;
- depression and anxiety;
- apathy and loss of interest;
- alcohol and substance misuse;
- increased risk of thoughts of self-harm.
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Thinking
- memory decline, particularly for recent events;
- difficulty with concentration and planning;
- slowed thinking;
- in later stages, marked decline extending to dementia.
Movement — usually later
- slowness, stiffness, tremor;
- impaired balance and gait;
- indistinct speech;
- difficulty swallowing.
When to see a doctor
- you have a history of many blows to the head and have developed changes in memory, mood or behaviour;
- those close to you notice you have become sharper, more impulsive or more withdrawn;
- memory and the ability to plan have worsened;
- tremor, stiffness or balance problems have appeared;
- your mood has dropped or you have thoughts of self-harm — seek help immediately;
- you have just taken a blow to the head and have headache, nausea, drowsiness, confusion or visual disturbance — this needs urgent care;
- you are continuing to train after a concussion — discuss this with your doctor without fail.
How it is assessed
There is as yet no test that confirms the diagnosis during life. Assessment serves a different and very important purpose: to exclude conditions that look similar but are treatable. These include depression, sleep apnoea, vitamin B12 deficiency, thyroid disease, the effects of alcohol, medication side effects, chronic subdural haematoma, normal pressure hydrocephalus, Alzheimer's disease and other dementias.
Brain MRI, neuropsychological assessment, blood tests and evaluation of mood and sleep are carried out. Studies using newer imaging techniques and blood markers remain experimental.
Prevention is the main thing
- do not return to activity until concussion symptoms have completely gone — the most important rule; a second injury to a brain that has not recovered is particularly dangerous;
- follow graduated return-to-play protocols after a concussion;
- limit the number of contact training sessions, particularly blows to the head in training;
- in children's sport, limit heading and contact elements;
- use the protective equipment provided; a helmet protects against skull fractures but does not remove the risk of concussion, and that is important to understand;
- train coaches and parents to recognise the signs of concussion;
- do not conceal symptoms in order to play — the most widespread and most costly mistake;
- seek help in situations of domestic violence.
What to do if symptoms are already present
There is no treatment able to halt the process, but the manifestations can be worked on, and the result can be substantial:
- treating depression and anxiety;
- addressing impulsivity and aggression, including behavioural therapy;
- stopping alcohol — it clearly worsens the picture;
- treating sleep disorders, including apnoea;
- cognitive rehabilitation and external supports — notes, reminders, routines;
- physiotherapy where there are movement problems;
- regular physical activity;
- family support and groups of people with similar experience;
- control of blood pressure, glucose and lipids — vascular health affects the course.
Common questions
Will one concussion cause CTE? No. The risk relates to repeated impacts over years.
Can it be diagnosed during life? Definitively, not yet. But assessment is still needed — to find and treat what is treatable.
Will all boxers and footballers develop it? No. The risk is raised, but the condition does not develop in everyone, and the factors determining that are still being studied.
Does a helmet protect? Against skull fractures, yes. Against concussion, no, because the brain moves inside the skull.
Can I keep playing sport? That is an individual decision with your doctor, based on your injury history and symptoms.
Online consultation
In an online consultation the doctor takes a history of your head injuries, assesses symptoms affecting memory, mood and movement, plans investigations to exclude the conditions that are treatable, and helps you build a safe training regime if you are continuing in sport.
This material is for information only and does not replace a medical consultation.
Medically reviewed by
Reviewed on Jul 4, 2026
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