Abstract
Case Presentation An ex-prisoner with history of repeated head injuries, presented with uncontrolled epilepsy.
CTE is a new, putative, pathological diagnosis, correlated with repeated head injuries.
Does repeated, mild, head injury, lead, inexorably and exclusively, to a unique pathological diagnosis?
Methods Review of apt literature on CTE and Epilepsy, neuropathology of head injury.
Results Contents of the skull are variably-deforming and subjected to varying haemodynamic and gravitational pressures (negative, positive and turning).
The key pathologic findings in CTE are: Head trauma in CTE pits normal brain structure and function against brief but large forces applied to the skull.
The definitional classification of CTE as "an accumulation of abnormal hyperphosphorylated tau (ptau) in neurons and astroglia distributed around small blood vessels at the depths of cortical sulci and in an irregular pattern", remains contentious.
As active team sports play a large part in the social fabric of Western society, the determination of this pathological picture warrants rigorous scrutiny.
The definition - a pathological picture and an immuno-reaction - is too general and cannot yet be extended into a clinical application.
The underlying cause of the pathological picture - in terms of possible genetic, biochemical and cellular predispositions - requires clarification.
Conclusion As the scales of spatial and temporal resolution of pathology specimens improve, it is inevitable that classifications of disease change.
Issues arise with claims of pathology findings being "pathognomonic" through a circular argument.
Premature extrapolation, of pathology slide to clinical syndrome, with major import on lifestyle, should be avoided.
