Concussion Research Pioneer Bennet Omalu Returns to ‘Neurosurgery’ Journal

As first reported on this blog last month, Dr. Bennet Omalu has an important and comprehensive article in an upcoming issue of the journal Neurosurgery. A pre-publication electronic version of the article by Omalu and the team at the West Virginia Brain Injury Institute, “Emerging Histomorphologic Phenotypes of Chronic Traumatic Encephalopathy [CTE] in American Athletes,” is now available. The abstract is at http://journals.lww.com/neurosurgery/Abstract/publishahead/Emerging_Histomorphologic_Phenotypes_of_Chronic.99380.aspx. The full article can be downloaded by journal subscribers, or by non-subscribers for $40.

I purchased my own copy of the article, and the interpretations of it here are my own.

Some highlights:

· It is noteworthy that 74 years elapsed between the first recognition in medical literature of permanent brain damage in boxers (dementia pugilistica or “punch drunk syndrome”) in 1928 and Omalu’s discovery of CTE in 2002.

· The population or “cohort” of postmortem brains studied to date by the Omalu group has turned up evidence of “incipient” CTE in an 18-year-old who had been playing football for six years.

· Omalu et al. say that the absence of portions of the brain for autopsy study does not preclude identifying CTE in available tissue.

· Despite press last year suggesting a link between CTE and Amyotrophic Lateral Sclerosis, or “Lou Gehrig’s Disease” – perhaps even, retrospectively, for Gehrig himself – the Omalu team says the two pathologies are not related (though they can co-exist).

· “Given the limited number of whole brains in our emerging cohort, we strongly recommend that CTE diagnosis and surveillance should no longer be regarded as empirical research requiring family consent. Rather CTE diagnosis and surveillance should become intrinsic components of routine patient care work-ups and routine hospital/medical examiner autopsies in high risk cohorts like athletes.” If implemented, this recommendation would appreciably accelerate public understanding of the CTE phenomenon. Some constituencies – notably retired and disabled National Football League players contemplating legal action – are dissatisfied with the current pace of the release of findings.

***

A NOTE ON PRO WRESTLER CHRIS BENOIT AND WORLD WRESTLING ENTERTAINMENT LAWYER JERRY McDEVITT

Though not identified by name, “case five” of this article refers to Chris Benoit: “acute cerebral parenchymal contusions due to blunt force trauma of the head, as well as sparse to marked perivascular and intramural lymphocytic infiltration of many penetrating parenchymal vessels.” (This according to Mike Benoit, the father, who has read the article.)

That, in turn, leads me to attempt to set to rest the attacks on the Benoit findings by Jerry McDevitt, the lawyer for World Wrestling Entertainment. (The full political background of McDevitt’s innuendos was developed in my February 8 blog post, at https://wrestlingbabylon.wordpress.com/2011/02/08/exclusive-dr-bennet-omalu-barred-from-publishing-chris-benoit-brain-findings-in-neurosurgery-has-a-new-article-scheduled-for-the-journal%E2%80%99s-march-2011-issue/.)

I have had the practice of publishing in full McDevitt’s legal threats to me. I do so in the interest of transparency and fairness. I have said repeatedly that his wild ancillary accusations against Omalu of chain-of-custody abuse with Benoit’s brain are laughable smear tactics. One consequence is that Omalu, who is chief medical examiner of San Joaquin County, California, and widely used as an expert in cases in other jurisdictions, often finds himself subjected to attacks from opposition counsel that are based on out-of-context quotes from McDevitt’s December 16, 2010, letter to me and accompanying exhibits.

Irv Muchnick

FURTHER READING

‘Never Mind the Lockout – Make NFL Pay Its Fair Share of the National Sports Concussion Tab’ … today at Beyond Chron

Concussion Inc.: CTE Expert Robert Cantu Has Confused Relationship With Xenith Helmet Company

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