Learning objectives for Azad et al. TBI

Question 1

explain the difference between concussive and sub-concussive mild traumatice brain injury

Answer 1

• Mild TBI results from traumatic diruption of the brain function with cognitive sequalae that range in severity from transient focal neurological deficits to loss of consciousness
• concussion is related to mild TBI, although its definition is more elusive. “a complex patholohical process affecting the brain, induced by biochemical force.
• concussion is a subset of mild TBI, although mild TBI can include subcincussive impacts as well.

Question 2

Descibe the characteristics of the syndrome that is thought to result from repetitive mild tbi: chronic traumatic encephalopathy (CTE). include a description of the histopathological criteria for a diagnosis of CTE

Answer 2

• CTE is a neurodegenerative disease pathologically confirmed by the presence of a unique patter of hyperphosphorylated tau neurofibrillary and astrocytic tangles in the brain. Tao proteins are misfolded and unable to be discarded.
• diagnosis ca only happen postmortem

Question 3

Descibe the case study of junior Seau

Answer 3

• Seau had complained of headaches, insomnia and episodes of dizziness.
• seau had behavioral changes such as drinking, gambling and financial decision changes.
• Seau became more aggressive and violent.
• Seau commited suicide at age 43
• Seau’s autopsy revealed “multifocal tauopathy consistent of a diagnosis of a chronic traumatic encephalopathy.”

Question 4

summarize the 4 stage system of CTE categorization purposed by McKee at al.

Answer 4

1. Tau neurofibillary tangles in focal epicenters at sulci depths in the cerebral cortexes. Some axonal loss.
2. Spread of the tao pathology to superficial cortical layers adjacent to the focal epicenters. Some axonal loss.
3. Tau pathology widespread and dense in frontal, insular, temporal, parietal and septal cortices, dicephalon, brainstem, ans spinal crod; also in medical temporal lobe, including hipposcampus, entorhinal cortex, and amygdala. Evidence of mild cerebral atrophy and depigmentaion of substancis negra. severe and diffurse axonal loss.
4. Widespread tau pathology in most regions of the crerbral cortew and medial temporal lobe. Further atrophy and gross abnormalities that are more severe than previous stages. Abundant neuronal loss and liosis of cerebral cortex and areas such as the amygdala and the hippocampus. Marked astrocytic triangle presence and neuronal loss of gliosis of the cerebral cortex, amygdala, and hippocamous. Severe and diffuse axonal loss.

Question 5

Summarize the risk factor of CTE

Answer 5

No proof of causation but there is a correlation between repetitive mild tbi’s an CTE.