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Early detection of brain injuries could help prevent future tragedies

Posted: January 30, 2013 - 12:03am
FILE - In this Oct. 7, 2007 file photo, New England Patriots linebacker Junior Seau runs with the ball after an interception during New England's 34-17 win over the Cleveland Browns in a football game at Gillette Stadium in Foxborough, Mass. The family of Junior Seau has sued the NFL, claiming the former linebacker's suicide was the result of brain disease caused by violent hits he sustained while playing football. The wrongful death lawsuit, filed Wednesday, Jan. 23, 2013 in California Superior Court in San Diego, blames the NFL for its "acts or omissions" that hid the dangers of repetitive blows to the head. Helmet manufacturer Riddell Inc., also is being sued by the Seaus, who say Riddell was "negligent in their design, testing, assembly, manufacture, marketing, and engineering of the helmets" used by NFL players.  (AP Photo/Winslow Townson)  Winslow Townson
Winslow Townson
FILE - In this Oct. 7, 2007 file photo, New England Patriots linebacker Junior Seau runs with the ball after an interception during New England's 34-17 win over the Cleveland Browns in a football game at Gillette Stadium in Foxborough, Mass. The family of Junior Seau has sued the NFL, claiming the former linebacker's suicide was the result of brain disease caused by violent hits he sustained while playing football. The wrongful death lawsuit, filed Wednesday, Jan. 23, 2013 in California Superior Court in San Diego, blames the NFL for its "acts or omissions" that hid the dangers of repetitive blows to the head. Helmet manufacturer Riddell Inc., also is being sued by the Seaus, who say Riddell was "negligent in their design, testing, assembly, manufacture, marketing, and engineering of the helmets" used by NFL players. (AP Photo/Winslow Townson)

KANSAS CITY, Mo. - A boy is dying on the sideline of a high school football game. He is 17 years old, a straight-A student, athletic, the standout running back and homecoming king. His mother is there, pleading for her Nathan to open his eyes. He can’t.

This nightmare is the awful product of a hundred outcomes all turning worst-case. A childhood in suburban Kansas City marked by freak accidents. A golf ball to the head. A slam into the wall. A baseball that slams between the eyes. More recently, a concussion in a high school football game.

He was a star on this night. Two touchdowns on offense. So many tackles on defense. Then, chaos. Nathan had tears in his eyes. He screamed to his friends that his head hurt. He collapsed, doctors gathering around him while the noise and pageantry of a Spring Hill High School football game played around them. The Life Flight helicopter is en route.

Nathan Stiles died in the hospital that night from something called “second-impact syndrome” - a re-bleed of a brain bruise, likely suffered in a previous game, that had not completely healed. Later, he was found to be the youngest known case of chronic traumatic encephalopathy, a brain disease most often linked with longtime professional football players. Nathan’s brain was already developing the same deadly build-ups seen in longtime professionals.

Medicine and technology was overmatched. CTE did not directly kill Nathan, but his parents say they would’ve kept him out of football if they knew the disease was forming in his brain.

Today, just over a year later and in the lead-up to the Super Bowl, a doctor is talking about a breakthrough he describes as the “holy grail” that might - might - help prevent future tragedies often linked to head trauma in football players and military veterans.

The problem with detecting CTE, the type of brain injury that so often shows up in football players, boxers, military veterans and others who’ve suffered repeated head trauma, is that it couldn’t happen until the person already died.

CTE is marked by a buildup of tau protein that could only be detected by cutting into a brain. You might suspect the chronic disease in an old football player, but you couldn’t know until the autopsy. Most recently and perhaps most famously, this is what happened after former Pro Bowl linebacker Junior Seau’s suicide.

“It’s frustrating,” says Julian Bailes, co-director of NorthShore Neurological Institute outside of Chicago. “We can only diagnose people from the grave, so to speak.”

That may be changing. Bailes is a co-author of a pilot study done at UCLA. Bailes’ team used a patented brain-imaging tool and found CTE markers in five living former football players. One of the patients is Wayne Clark, a 64-year-old who was a backup quarterback for three teams, including the Chiefs. Another is Fred McNeill, a 59-year-old who played linebacker 12 years for the Vikings. The three others were not identified by name, but are a 73-year-old former guard, a 50-year-old former defensive lineman and a 45-year-old former center.

The study - peer-reviewed to consensus if cautious optimism - found dense tau protein deposits in parts of the brain where CTE typically shows. A critical point is that what the UCLA team found looks different than diseases with similar effects to the brain, such as depression or Alzheimer’s.

Play it forward, and it’s easy to imagine a day when CTE tests on living athletes are widely used and seen as critically important. Just like an athlete can get a test on his knee ligaments, he could get one on his brain. Both would help inform a decision on whether he should play.

Bailes and the rest of his team have been careful to describe their findings as “preliminary.” This is only a pilot study, after all, and there remains no cure for CTE. But the indications are promising, and the possibilities are life-saving.

“If someone was suspected to be developing CTE, you’d possibly use this to see how much tau protein burden they have,” Bailes says. “It’s something you’d use to determine if someone has a likelihood of developing CTE.”

At that point, doctors could treat the disease or keep the patient out of harm’s way. Either way, lives could be saved. The findings are being promoted primarily as an aid to former players who want to know if they have CTE. But Stiles’ case - he didn’t die of CTE, but his brain was developing it - shows you don’t have to be an NFL veteran to potentially benefit.

It’s easy to imagine Bailes’ findings someday saving lives both young and old.

Ron Stiles is not what many might expect in a grieving father who lost a son to a football game. He doesn’t blame football, necessarily. Once, pushed by a reporter, he said he’d rather people stop riding motorcycles than play football. His lesson from this is that nothing in life is guaranteed, which is why his family has prioritized spreading Nathan’s strong faith over awareness for head injuries.

All that said, Stiles is moved by this study’s significance.

“If we’d known b?&” he says, his voice trailing off for a moment. “We don’t know when CTE came on him, but football is something we wouldn’t want him doing if we’d have known. Would he have been alive today? I can’t answer that.”

Bailes can’t either, though the possibility is there. In theory, if Stiles knew he was developing this deadly protein in his brain, he could’ve quit football earlier and held off the full onslaught of this deadly disease. There are still too many uncertainties to know for sure.

The potential of preventing cases like Stiles’ only furthers the importance of these findings, because younger players aren’t even the focus. Bailes sees this first as a way to help old professionals, and guide active players’ decisions on whether to retire. Future cases like Stiles’ could be an invaluable aid in learning more about CTE, as well as help younger players navigate the dangers.

So much of the news around this has been tragic. Finally, in the days before the country’s biggest sports party, a new hope that fewer parents will know the unthinkable pain of watching their child die from a game.

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