The neuropathology of chronic traumatic encephalopathy

Chronic traumatic encephalopathy (CTE) is a progressive tauopathy causally linked to repetitive mild traumatic brain injury. Currently, there are no established clinical diagnostic criteria for CTE, making post-mortem neuropathological examination essential for diagnosis. The pathological hallmark of CTE is the presence of perivascular neuronal p-tau aggregates at cortical sulcal depths. In this commentary, we share our diagnostic experience, highlight emerging diagnostic protocols for CTE, and discuss the challenges in CTE diagnosis and its differentiation from comorbid conditions. Beyond the neuropathological insights, we explore the broader implications of CTE for the community, including the need for prevention strategies and the role of public health policy. By advancing understanding of CTE pathology, neuropathologists are positioned to inform prevention and treatment efforts, ultimately contributing to the mitigation of this preventable disease.