Football Participation and Chronic Traumatic Encephalopathy

A 13-year-old male athlete presents to the clinic with his parents for a preparticipation physical examination. The athlete has participated in soccer, baseball, and track in the past but is very interested in joining the football team this year. His parents are hesitant for him to participate in football because they have heard about a brain injury in football players called chronic traumatic encephalopathy (CTE). They would like your advice regarding whether their child should avoid football due to the risk of developing CTE. The athlete is an aboveaverage student and aspires to go to college and become an engineer. He has no significant medical or surgical history. Specifically, he has never sustained a previous brain injury. He does not take any medications. He does not have a history of psychiatric disorder or learning disability. He denies smoking, drinking alcohol, or taking illicit drugs. His family history is significant for migraine headaches in his mother and maternal grandmother. Dr Scott Laker will argue that the benefits of participating in football outweigh the risks of developing CTE and would counsel the patient to participate in football if they so desire. Dr Christine Griess will argue that collision sports, especially American football, increase the chances of CTE andwould counsel the patient not to participate.