Trauma (Slow onset, progressive)
Clinical presentation
Classical history of repetitive head injury, usually as a consequence of playing contact sports. Concussion is a major risk factor.
Diagnosis
Definitive diagnosis at autopsy – reveals deposition of neurofibrillary tangles, mainly in the cortex.
Patho-mechanism
Recurrent head trauma causes diffuse neuronal injury and loss, scarring, and tau protein deposition.
Associated features
Cognitive impairment, mood disorders, changes in personality and behavior, parkinsonism, and gait and speech abnormalities are common.