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Comment & Response
August 2016

Chronic Traumatic Encephalopathy in a 25-Year-Old Athlete—Distribution of Lesions

Author Affiliations
  • 1Accident Compensation Corporation of New Zealand, Shamrock House, Thorndon, Wellington, New Zealand
JAMA Neurol. 2016;73(8):1033. doi:10.1001/jamaneurol.2016.1396

To the Editor In the article by Mez et al,1 half (5 of 10) of the lesions in the thin section specimen (panel B in the article’s Figure) stained for AT8, are in the sulcal depths of gyri. Is this characteristic of chronic traumatic encephalopathy?

If these lesions result from an impact-induced wave in the cerebrospinal fluid of the subarachnoid space, they would be found at the blind end of a subarachnoid space in the sulcus. A pressure wave would stretch and tear the cortex where it hit the end of the sulcus. This fits with the known physics of pressure transfer across a curved membrane, in this case, the fold at the depth of the sulcus.