Persistent Cognitive Impairment in Multiply Concussed Female Athletes: Is it CTE? Two Case Reports
Recent reviews of current issues in pediatrics sports concussion have concluded that there appears to be a growing population of multiply concussed young athletes who may experience as-yet-undiagnosed cognitive impairments later in life. In addition, and more ominously, repetitive mild head trauma has been linked to chronic traumatic encephalopathy (CTE). Chronic traumatic encephalopathy is a progressive neurodegenerative disease thought to be caused, at least in part, by multiple concussive or subconcussive head impacts associated with sports as well as other head trauma. Early appearing symptoms included apathy and impairments in attention, memory and executive functioning. Despite the fact that female athletes sustain more concussions than male athletes in similar sports, the study of chronic traumatic encephalopathy in females is virtually non-existent. The article reports two cases of multiply concussed former female athletes in their twenties who have presented with the early appearing, worsening symptoms of CTE for 5 to 10 years. Although a definite diagnosis can only be made by a post-mortem neuropathological examination, the fact that these symptoms cannot be plausibly explained in any way other than resulting from repetitive concussive head impacts strongly suggests CTE and underscores the need for the study of CTE in females.
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