How to Spot the Warning Signs of Brain Trauma — And Prevent the Injuries That Lead to It

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CTE doesn’t just happen to pro athletes.

Chronic traumatic encephalopathy, otherwise known as CTE, is usually associated with professional sports like football and hockey — but you don’t need to be an NFL athlete to sustain serious head trauma.

Recent studies into the prevalence of CTE have even revealed that it affects the non-athlete population more than scientists previously believed. Current data estimates that about 9 percent of athletes show evidence of CTE, while 3 percents of non-athletes do. These may seem, at first, like relatively low numbers — but when you consider just how big the population of “non-athletes” is in the United States, that 3 percent starts to look a whole lot bigger.

Compounding this stat is the lack of awareness most people seem to have about brain trauma. CTE is so heavily connected in the media to professional sports and military deployment that an average person would be forgiven for thinking it could never happen to them. This lack of awareness can lead to people missing critical warning signs, or sometimes not even knowing they had any trauma at all until they get a sudden and devastating diagnosis, like dementia, by which point the knowledge has come too late.

Something important to note here is that you can’t get a diagnosis for CTE while you’re alive. The condition can only be found during an inspection of the brain during an autopsy — and since only a small portion of the population ends up undergoing an autopsy after they die (and an even smaller percentage of the population elects to donate their brain to science), researchers only have a partial picture of how common CTE is in the general population.

These details above provide some context as to why people might not be aware of the prevalence of CTE. And seeing as how an estimated one in three senior citizens currently dies from Alzheimer’s or another form of dementia, it’s impossible to overstate how critical it is to be educated about head trauma and brain health overall.

Katie Couric Media spoke to three experts about CTE to better understand how it happens, what the symptoms are, and how you can protect your noggin from future brain injuries.

How does CTE impact your brain health?

When you hit your head once, you might sustain a concussion, which occurs when a jolt to the head causes the brain to move rapidly back and forth. In most instances, a single concussion doesn’t cause permanent damage.

However, when you hit your head again and again, and your brain gets jostled more and more, you run the risk of developing a more permanent brain injury. That’s CTE.

“CTE is caused by repetitive head trauma, often in the setting of contact or collision sports-related injuries,” explains Dr. Kevin Bieniek, Ph.D., an assistant professor at The University of Texas Health Science Center at San Antonio, and an investigator in UT Health San Antonio’s Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases. “Observations of CTE pathology outside of the sports setting are uncommon, but CTE or CTE-like pathology has been reported in other instances of individuals who’ve experienced multiple traumatic brain injuries.”

A traumatic brain injury might happen when you fall off a ladder, or it could happen for those who experience domestic violence. It can also happen in less-conventional scenarios, Dr. Bieniek notes, “including [instances of] uncontrolled epilepsy, and even an individual with self-injurious head-banging behavior in the setting of music concerts.”

As we noted in the introduction, current estimates peg CTE occurrence in non-athletes to be at a minimum of 3 percent of the overall population — but the actual number could be much greater.

“We have looked at brains [that have been donated to science] outside of the professional sports world and found CTE pathology — typically very mild — in a small subset of about 6 percent of cases,” Dr. Bieniek explains. “Even amongst those cases, most had past histories of participation in high school, collegiate, or amateur contact sports.”

In other words, you don’t have to be a professional athlete to incur a traumatic brain injury. It’s possible that you sustained a brain injury while playing football or volleyball or soccer in high school, without even realizing it.

What are the symptoms of CTE?

If you aren’t and have never been a professional athlete, it’s likely that CTE hasn’t even been on your radar. That’s why it’s so important to understand the signs of this type of brain trauma so that you can be a brain health advocate for yourself and for your loved ones.

“CTE symptoms include those related to mood and behavior, such as problems with impulse control, aggression, mood swings, depression, paranoia, or anxiety,” says Julia Manning, senior director of communications and programs at the Concussion Legacy Foundation.

Other symptoms of CTE include “those related to cognition, such as short-term memory loss, confusion, impaired judgement, which in some cases can lead to dementia. Additionally,” Manning notes, “there have been reports of sleep disturbances.”

Can CTE be treated?

Unfortunately, there isn’t a silver bullet solution for CTE. In fact, by the time you have that level of brain trauma, it’s usually too late for any type of treatment whatsoever.

“Like most neurodegenerative disorders, CTE is progressive, and there are no confirmed treatments for CTE at this time,” Dr. Bieniek says. “However, since CTE pathology is similar to the pathology of Alzheimer’s disease and other related neurodegenerative disorders, and as we continue to study treatments of Alzheimer’s and other dementias, we will hopefully also get closer to uncovering treatments to address CTE.”

If there’s a single big takeaway here, it’s a simple one: You only have one brain, which is why it’s so important to keep it protected — especially when you’re younger, because most brain trauma tends to compound over the decades. (More on how to do that effectively in just a minute.)

How does CTE impact your brain over time?

There’s a certain irony to the way that brain health manifests within a person’s life through the years: As you get older, you may find yourself in fewer and fewer positions where your brain is at risk — but any brain trauma you might have sustained when you were younger might start presenting with worse and worse symptoms as you age.

“Depending on the stage of the disease, CTE can hinder a variety of brain functions, including memory, attention, personality, and motor symptoms that mimic Parkinson’s disease,” explains Madeline Uretsky, the research program manager at Boston University CTE Center. “It is a progressive disease, so symptoms get worse over time. It starts with minor cognitive difficulties and mood disregulation, and eventually ends with dementia.”

 In more severe cases of CTE, Uretsky notes, individuals can have trouble completing daily activities such as “cooking, driving, remembering appointments and medications, and reading, due to the clinical presentation of dementia or mild cognitive impairment.”

Of course, these symptoms can vary significantly from person to person, depending on your age, the extent of your brain trauma, and more.

How to avoid brain damage as much as you can, at any age

So now you’ve been given all of this important (and, let’s be honest: terrifying) information about brain trauma, you might be wondering what to do about any of it.

Besides opting out of an NFL contract or a military deployment, is there any way to greatly minimize your risk of incurring brain damage?

The answer is yes — and the solutions are actually much simpler than you’d think. One of the best things you can do to avoid concussions, brain damage, and an eventual CTE diagnosis is… drumroll, please

Wear a helmet.

When you’re biking, wear a helmet. When you’re skiing, wear a helmet. When you’re walking through the construction site of your mid-renovation home, wear a helmet. “Traditional approaches to preventing injury — including helmets, hard hats, and other head protection, securing and working in a safe environment, and avoiding activities with the potential for head trauma — all make a meaningful difference in mitigation efforts,” Dr. Bieniek says.

Another tip is to minimize your daily risk of falling. If you have to go up and down the stairs often, consider carpeting those stairs, or wearing socks with treads on them to help you keep from slipping.

If you do sustain a head injury despite taking precautions, see a health professional immediately.

“Reducing risk of CTE largely involves reducing an individual’s exposure to repetitive head trauma,” Dr. Bieniek explains. “However, even a single traumatic brain injury increases risk for dementia broadly.”

That’s why it’s important to see a doctor even if it’s your first head injury — or at least, the first head injury in recent memory that you can think of. “Consult with your care provider, adhere to the advised treatment and recovery measures, and avoid other immediate injuries,” Dr. Bieniek suggests.

Lastly, if the topic of brain health is as vitally important to you as it is to us, consider donating your brain and other organs to science as a gift to future generations. The more information scientists are able to gather about neurological diseases, the more quickly we can eradicate these diagnoses for good.

Want even more must-read insights on how to keep your brain at its best? Check out our entire Inside Your Mind series right here.