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Chronic Traumatic Encephalopathy, Suicides and Parasuicides in Professional American Athletes: The Role of the Forensic Pathologist

Omalu, Bennet I. MD, MPH; Bailes, Julian MD; Hammers, Jennifer Lynn DO; Fitzsimmons, Robert P. JD

The American Journal of Forensic Medicine and Pathology: June 2010 - Volume 31 - Issue 2 - p 130-132
doi: 10.1097/PAF.0b013e3181ca7f35
Original Article

We present 5 cases of professional American contact sport athletes who committed parasuicides and suicides aged 50, 45, 44, 36, and 40 years old. Full forensic autopsies and immunohistochemical analyses of the brains revealed chronic traumatic encephalopathy (CTE). The brains appeared grossly normal at autopsy without gross evidence of remote traumatic injuries or neurodegenerative disease. Brain immunohistochemical analyses revealed widespread cerebral taupathy in the form of neurofibrillary tangles and neuritic threads without neuritic amyloid plaques. CTE refers to chronic cognitive and neuropsychiatric symptoms of chronic neurodegeneration following a single episode of severe traumatic brain injury or repeated episodes of mild traumatic brain injury. CTE can only be definitively diagnosed by direct tissue examination. Without full autopsies and immunohistochemical brain analyses these cases would never have been identified. Forensic pathologists will play a vital and central role in the emerging disease surveillance of CTE in professional American athletes, in the identification of CTE cases, and in the establishment of the epidemiology of CTE, with the goal of eventually developing preventive and interventional therapeutic protocols for CTE outcomes.

From the Brain Injury Research Institute, West Virginia University.

Manuscript received October 21, 2008; accepted December 12, 2008.

Reprints: Jennifer Lynn Hammers, DO, City of New York, Office of the Chief Medical Examiner, 520 First Avenue, New York, NY 10016. E-mail:;

© 2010 Lippincott Williams & Wilkins, Inc.