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Chronic Traumatic Encephalopathy

Medically reviewed by Last updated on Aug 31, 2022.

What is chronic traumatic encephalopathy (CTE)?

CTE is permanent brain damage caused by repeated traumatic brain injuries, such as concussions. Encephalopathy is a term used to describe brain disease or brain damage. A concussion is an injury that causes the brain to hit the skull. After several concussions, certain proteins may start to replace healthy brain tissue. The proteins prevent the brain from working properly.

What increases my risk for CTE?

  • Concussions from military combat, contact sports such as football, or accidents
  • Lack of rest between concussions
  • A disease that causes inflammation, such as diabetes or obesity
  • A family history of dementia

What are the signs and symptoms of CTE?

CTE develops slowly, over decades. Signs and symptoms may be mild at first and become more severe over several years. You may have any of the following:

  • Problems paying attention, keeping a train of thought, or remembering things
  • Confusion or disorientation (not knowing where you are or what day it is)
  • Dizziness or headaches
  • Impulsive actions, such as reckless driving or unprotected sex
  • Personality changes, or getting angry easily
  • Depression or thoughts of suicide
  • Movement or muscle problems, such as clumsiness, tremors, or muscle twitches

How is CTE diagnosed and managed?

Currently, CTE cannot be diagnosed through any tests. Your healthcare provider may suspect you have CTE if you have personality or other changes. Tell him if you have a history of concussions, and when they occurred. He or she may also do a neurologic exam to check how well your brain works. He or she will check how your pupils react to light. He or she may check your memory, hand grasp, and balance. CTE cannot be cured, but the symptoms can be managed:

  • Create routines. Create a schedule for doing daily activities. CTE symptoms are often worse at night. Go to bed and get up in the morning at the same times every day. Talk to your provider if you have trouble going to sleep or staying asleep.
  • Go to physical, occupational, or emotional therapy as directed. A cognitive behavioral therapist teaches you skills to help with any thinking and behavior problems you may have. A physical therapist can help you with balance, coordination, and muscle control. An occupational therapist can help you learn ways to do your daily activities. For example, you may create a daily activity calendar. Emotional therapy includes talking with a therapist alone or with family members about your symptoms.
  • Ask for support and help. Explain your symptoms to others. Ask them to be patient and to repeat information if needed. A calm, supportive environment can help prevent bursts of anger or other mood problems.
  • Exercise as directed. Exercise can help prevent mood swings. Exercise also helps with muscle coordination and motor skills. You may also sleep more easily with regular exercise. Talk to your provider about the best exercises for you. A stationary bicycle or exercises done in a chair may be safer if you have trouble walking.
  • Keep your thinking skills active. Do activities that make you think. Some examples are crossword puzzles, learning to read music, and solving jigsaw puzzles.
  • Eat a variety of healthy foods. Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Healthy foods can help keep your brain healthy.
  • Limit or do not drink alcohol as directed. Alcohol can make your symptoms worse and cause more brain damage. Ask your provider if it is safe for you to drink alcohol.
  • Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause blood vessel and brain damage. Ask your provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your provider before you use these products.

What can I do to prevent CTE?

CTE develops slowly, over time. You may be able to decrease your risk by preventing concussions:

  • Wear protective sports equipment that fits properly. Helmets help decrease your risk for a serious brain injury. Talk to your provider about ways you can decrease your risk for a concussion if you play sports.
  • Rest after a concussion. If you do have a concussion, give your brain time to rest and heal. Do not try to play sports again too quickly after a concussion. Your provider can tell you when it is okay to return to sports.
  • Wear your seat belt every time you travel. This helps to decrease your risk for a head injury if you are in a car accident.

Where can I find more information?

  • Brain Injury Association
    1608 Spring Hill Road
    Vienna , VA 22182
    Phone: 1- 703 - 761-0750
    Phone: 1- 800 - 444-6443
    Web Address:

Call 911 or have someone else call for any of the following:

  • You want to harm yourself or another person.
  • You cannot be woken.
  • You have a seizure.

When should I seek immediate care?

  • You have another head injury.

When should I contact my healthcare provider?

  • You have new or worsening symptoms.
  • You have trouble sleeping or doing your daily activities.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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