Originally published May 1, 2013 at 10:58 a.m., updated May 1, 2013 at 11:30 a.m.
Dr. Alexander Khalessi, Co-Director of Neurovascular Surgery at UC San Diego
On May 2, 2012 San Diego was stunned by the death of former Chargers linebacker Junior Seau.
Seau's fatal self-inflicted gunshot to the heart at age 43 was inexplicable at first but then speculation began that Seau's suicide might be linked to repeated brain injuries.
Eventually, medical studies revealed that his brain showed signs of chronic traumatic encephalopathy or CTE.
While many people and organizations in San Diego, and especially in Oceanside, are still coming to terms with the death of this sports superstar, both the medical and legal professions are involved in writing a final chapter in this story.
"Anytime when you have the tragic loss of a public figure like Junior Seau, there's a renewed public interest on brain injury," Dr. Alexander Khalessi, co-director of Neurovascular Surgery at UC San Diego, said.
Over the last 12 months, much has been learned about the science behind brain injuries and since Seau's death there's been added momentum to concussion-related lawsuits against the National Football League.
The National Institute of Health discovered Junior Seau had a degenerative brain disease known as CTE or chronic traumatic encephalopathy when he shot himself in the chest last May.
CTE is degenerative brain disease. The disease can be caused by concussions but the disease could also be triggered by repeated blows to the head or sub-concussions. This type of trauma can lead to memory loss, depression, dementia, among other symptoms.
"CTE is the first condition we know across neurosciences where an environmental factor, repeated blows to the head, can prompt the progressive neurodegenerative changes in the brain," Khalessi said.
While the condition has only been definitively diagnosed postmortem, research on brain trauma is advancing. A recent UCLA pilot study identified the tau protein, which is associated with CTE, in the brains of retired football players.
"We are making progress in taking what was once an autopsy diagnosis and using more sophisticated imaging to diagnose these things in a way that we can intervene for living patients," Khalessi added.
New research sounds promising, but there is still a lot that we don't know about how CTE is caused. For example, how many concussions can lead to the disease? Does it depend of the severity, type or the individual? Those are some of the many unanswered questions that researchers are exploring.
They're also looking into whether there is a genetic predisposition to CTE. Currently, there is no consensus on a cure or treatment of the disease.
The Legal Road
On the legal side, more and more former NFL players have filed concussion-related lawsuits over the last year.
The Seau family is part of more than 4200 lawsuits against the NFL currently making their way through federal court.
The lawsuits allege that the NFL hid the risks associated with repeated head injuries in football from the players.
"The NFL should be held responsible because they took on a role as safeguarding player safety they established the rules for player safety," said John Fiske, President of the San Diego Brain Injury Foundation and an attorney working with the Seau family
In 1994, the league established the Mild Traumatic Brain Injury Committee. But Fiske argues that the NFL tried to discredit much of the medical information that had been readily available for decades.
"And now we are seeing a lot of these rule changes that I think are result of these lawsuits bringing this issue to the public light."
The NFL has denied the allegations and said it is committed to supporting independent research into CTE and promoting the health and safety of athletes.