Article Text

Download PDFPDF
Chronic traumatic encephalopathy: Rugby's call for clarity, data and leadership in the concussion debate
  1. Jon S Patricios1,2,3,
  2. Simon Kemp4
  1. 1 South African Rugby Union (SARU), Newlands, Cape Town, South Africa
  2. 2 Section of Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
  3. 3 Department of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
  4. 4 Rugby Football Union, Twickenham, UK
  1. Correspondence to Dr Jon S Patricios, South African Rugby Union (SARU), Newlands, Cape Town 2121, South Africa; jpat{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

American Football first…

After US District Judge Judy Brody recently ruled that the consolidated multi-district concussion litigation cases against the National Football League (NFL) in the USA were to be transferred to a labour arbitrator, the NFL agreed to a $765 million settlement. More than 4000 current and ex-NFL players, the plaintiffs in this case, allege that the NFL has misrepresented the long-term health dangers associated with on-field head injuries.1 Either way, the debate about the potential long-term consequences of concussion will play out in the American media for a number of years to come, ensuring that the term chronic traumatic encephalopathy (CTE), a progressive neurodegenerative condition that is thought to occur as a consequence of repetitive mild traumatic brain injury, not only remains part of our clinical lexicon, but is also embedded in social media postings (‘#CTE’ on Twitter, ‘Heads Up! CTE’ on Facebook, 1740 YouTube videos, and 740 000 Google references)2 ,3 where the messaging today is simple and consistent: ‘contact sport damaged my brain and it didn't have to happen’.

… Ice Hockey follows…

Recently, the National Hockey League (NHL) has been sued by the family of a former NHL player in what has been described as ‘an explosive wrongful death lawsuit’ that allegedly resulted from a lethal combination of recurrent head injuries, in-game fighting, over-prescribed painkillers and CTE. American Football and Ice Hockey are not the only sports to be associated with CTE.4 Boxing was implicated in the very first medical descriptions of dementia pugilistica in prize-fighters in 1928,5 while in soccer, the possibility of significant brain injury as a result of repeated heading of the ball has again been reopened in the context of the CTE debate.6

… Will Rugby Union?

Rugby Union (hereafter just ‘Rugby’) is a collision team sport played by men, women, boys and girls in …

View Full Text


  • Contributors JSP and SK contributed to the researching and writing of this article.

  • Competing interests None.

  • Provenance and peer review Not commissioned; internally peer reviewed.