Chronic Traumatic Encephalopathy Lee Cearnal  Annals of Emergency Medicine  Volume 60, Issue 4, Pages A17-A21 (October 2012) DOI: 10.1016/j.annemergmed.2012.08.013 Copyright © 2012 American College of Emergency Physicians Terms and Conditions

Figure 1 Tau immunostained sections of medial temporal lobe from 3 individuals. Top left: Whole brain section from a 65-year-old control subject showing no tau protein deposition. Bottom left: Microscopic section from 65-year-old control subject also shows no tau protein deposition. Top middle: Whole brain section from John Grimsley showing abundant tau protein deposition in the amygdala and adjacent temporal cortex. Bottom middle: Microscopic section showing numerous tau positive neurofibrillary tangles and neurites in the amygdala. Top right: Whole brain section from a 73-year-old world champion boxer with severe dementia showing very severe tau protein deposition in the amygdala and thalamus. Bottom right: Microscopic section from a 73-year-old world champion boxer with severe dementia showing extremely dense tau positive neurofibrillary tangles and neurites in the amygdala (Reprinted with permission from Dr. Robert Cantu, Co-director of the Center for the Study of Chronic Traumatic Encephalopathy, Boston University, Concord, MA 01742). Annals of Emergency Medicine 2012 60, A17-A21DOI: (10.1016/j.annemergmed.2012.08.013) Copyright © 2012 American College of Emergency Physicians Terms and Conditions

Figure 2 Tau immunostained sections of frontal cortex from 3 individuals. Top left: Whole brain section from a 65-year-old control subject showing no tau protein deposition. Bottom left: Microscopic section from 65-year-old control subject showing no tau protein deposition. Top middle: Whole brain section from John Grimsley showing patchy deposition of tau protein in the frontal cortex. Bottom middle: Microscopic section from John Grimsley showing numerous tau positive neurofibrillary tangles and neurites in the frontal cortex. Top right: Whole brain section from a 73-year-old world champion boxer with severe dementia showing very severe, patchy tau protein deposition in the frontal cortex. Bottom right: Microscopic section from a 73-year-old world champion boxer with severe dementia showing dense tau positive neurofibrillary tangles and neurites in the frontal cortex (Reprinted with permission from Dr. Robert Cantu, Co-director of the Center for the Study of Chronic Traumatic Encephalopathy, Boston University, Concord, MA 01742). Annals of Emergency Medicine 2012 60, A17-A21DOI: (10.1016/j.annemergmed.2012.08.013) Copyright © 2012 American College of Emergency Physicians Terms and Conditions

Figure 3 Eighteen-year-old brain tissue; Top left: Whole mount section of frontal cortex showing very focal deposition of tau protein around small blood vessels (red box); Bottom left: High magnification shows dense tau immunoreactive NFTs around small blood vessels (holes) and extensive tau immunoreactive neurites in the neuropil immediately surrounding the area; Top right: Another whole mount section of frontal and insular cortex showing very focal deposition of tau protein around a small blood vessel in insulara cortex (red box). Bottom right: High magnification shows dense tau immunoreactive NFTs around a small blood vessel (hole) and tau immunoreactive neurites in the neuropil immediately surrounding the area (Reprinted with permission from Dr. Robert Cantu, Co-director of the Center for the Study of Chronic Traumatic Encephalopathy, Boston University, Concord, MA 01742). Annals of Emergency Medicine 2012 60, A17-A21DOI: (10.1016/j.annemergmed.2012.08.013) Copyright © 2012 American College of Emergency Physicians Terms and Conditions