Management of chronic traumatic encephalopathy

Introduction: Chronic Traumatic Encephalopathy (CTE) is a neuropathological disease defined by perivascular hyperphosphorylated tau protein depositions in a patchy distribution at the depths of cortical sulci in the brain. Presently, in living individuals, it cannot be precisely diagnosed or differentiated from other neurodegenerative diseases nor are there treatments for the underlying disease process. There are non-pharmacologic and pharmacologic treatments for the symptoms of CTE that improve the quality of daily life. That is the primary focus of this review article that used Pub Med and other standard databases but drew heavily from the author's personal experience managing patients at risk for CTE. Areas covered: The history and pathology of CTE, aiding the clinician diagnosing CTE as unlikely, possible, or probable in the living, and symptom treatment are the major areas discussed. Expert opinion: Diagnosing CTE during life with sensitive and specific biomarkers is the next critical step and only then will its incidence and prevalence, risk factors, and clinical features due to tauopathy versus axonopathy or other features be known.