Encefalopatía traumática crónica, definición, diagnóstico y prevención. Revisión de la literatura

Abstract

Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease which is produced as a consequence of repeated brain trauma: concussions, which are a clinical syndrome characterized by an alteration in brain functions5. A concussion, under strict definition, should not cause structural changes to the brain. Therefore, it would not be possible to see through images if there were changes at a microscopic, biochemical level1. Most patients see their symptoms completely resolved within 10 days (90%), but there is a small percentage which persists8, and these might cause a post-concussional syndrome, second impact syndrome of chronic traumatic encephalopathy3. CTE is characterized by the accumulation of hyper-phosphorylated Tau protein in neurons and astrocytes2. These appear in the form of neurofibrillary tangles. During the initial stages they are focalized in the frontal cortex and, in more severe cases, their distribution is more generalized, spreading through the majority of the regions in the brain9. It is diagnosis is done through histopathology. Thus, it has only been possible to do post mortem. New technologies associated with bio-markers and PET are being worked on to achieve a pre-mortem diagnosis. The greatest emphasis in the handling of this tauopathy lies in the prevention and the adequate handling of concussions.