Here’s What Really Happens with Repeated Blows to the Head

boxers boxing
Two boxers are competing in a game

Boxers, football players, and others who suffer repeated blows to the head can suffer serious consequences that can include memory loss, loss of limb or organ function, and cognitive impairments. They are also more prone to develop Alzheimer’s and other dementias. The rate of traumatic brain injuries in the United States continues to climb. Individuals involved in contact sports or other professional endeavors that put them at risk for head injury should know the dangers they face each time they head out on the field or head into work.

Chronic Traumatic Encephalopathy

Patients who suffer repeated blows to the head can develop Chronic Traumatic Encephalopathy (CTE). Individuals are also at increased risk of developing Alzheimer’s and other forms of dementia. The most common symptoms of CTE are loss of memory, changes to personality, and behavioral changes that can include prolonged depression and bouts of aggression. In many cases, these symptoms will not manifest until years or decades after the injury has occurred which can make it difficult for physicians to identify the precise cause. For instance, it is relatively easy to connect a boxer or football player’s head injuries to the sports they played. It is more difficult to connect the dots when it involves minor, seemingly inconsequential events that occurred decades earlier.

The symptoms of CTE are similar, but not identical to those of Alzheimer’s. The condition is identified by the same damage to the TAU-immunoreactive neurofibrillary tangles as well as the neuropil threads in the brain that result in cognitive decline. However, present medical science is limited in its ability to diagnose the condition while the patient is alive. There are no blood tests or other diagnostic tools that can confirm the presence of CTE. Indeed, the only way to currently identify CTE is during an autopsy and a subsequent examination of the individual’s brain tissue. Moreover, there is no treatment or cure for CTE. Once it develops the individual will suffer a progressive decline in mental and physical faculties.

Recognizing & Diagnosing Traumatic Brain Injury

It’s vital for parents, coaches, and caregivers to actively prevent head injuries through proper supervision and the use of protective equipment. It is also imperative that these individuals have the skills and training to recognize the signs and symptoms of a traumatic brain injury. These include the inability to remember suffering the injury, general confusion, disorientation, headaches, blurred vision, nausea, and vomiting. Individuals who have suffered a suspected brain injury should receive prompt treatment and supervision during the recovery process to prevent further injury. Further, individuals who have suffered a concussion or contusion shouldn’t be cleared to return to work or to sporting activities until they have received a thorough medical examination. 

Most traumatic brain injuries do not produce visible symptoms. Depending on circumstances and the individual’s score on the Glasgow Coma Scale, physicians may order a series of tests to determine the extent of the injury. This can include a CT scan or MRI. These can identify tissue swelling, broken blood vessels, blood clots, contusions, bone fractures, etc. This information can help physicians determine which parts of the brain are injured and whether medication or surgical intervention is required.

High-Risk Groups

CTE can affect anyone. However, there are certain individuals that are at higher risk than the general population. These include boxers, football players, and others who engage in sports with a high incidence of concussions. Similarly, skiers, soldiers, construction workers, and others who suffer repeated concussions have a higher incidence rate than the general public. Individuals in these high-risk groups can develop CTE even if the previous concussion occurred in the past and the individual has fully recovered from the earlier injury. Currently, it is unknown exactly how many concussions are required, or whether the severity of each concussion elevates the risk of developing CTE. Scientists currently believe that a series of even small, seemingly insignificant bumps on the head can be as devastating as a single large concussion. 

Early Diagnosis Provides Knowledge but Doesn’t Change Outcome

Scientists are currently working on the development of imaging agents that can accumulate at points of interest within a patient’s brain. These agents could make it possible to identify potential CTE during a PET or SPECT scan. However, limitations in current medical technology mean that treatment for CTE will remain limited. At best, patients who know they have the condition can prepare themselves and their families for what’s down the road. This may do more harm than good as it essentially puts patients in the position of saying long goodbyes with no hope of recovery from their condition. Even with extensive counseling, this knowledge can result in prolonged depression, suicidal thoughts, withdrawal from family/friends, and an immediate decline in quality of life.