Headed for Trouble

BU scientists are renowned for their research on concussions suffered by NFL veterans. Now their studies are raising alarming questions about the true dangers of high school football.

WALLY HILGENBERG’S BRAIN sits beneath a microscope. It does not look good. What should be a clean, off-white layer of tissue is instead covered in brown splotches. Peering at it, Dr. Ann McKee points out a group of gnarled brown marks in the hippocampus, the part of the brain that controls memory and learning. “You see all these tangles?” McKee asks. “These are just tremendously abnormal nerve cells…. There’s essentially no normal cell left.”

McKee is actually looking at the remnants of the late Wally Hilgenberg’s brain. The neuropathologist has dehydrated it, shrunk it, sliced it, and pressed it flat between two glass plates. It now looks like a piece of ginger, plucked from a sushi platter. A dye has been applied to highlight buildups of abnormal forms of tau, a protein that exists regularly in brain cells but, when mutated, may kill them. As McKee shifts the glass plates beneath the microscope, moving toward Hilgenberg’s cortex and down to the brain’s stem, all she finds is more brown, marking more dead cells. It looks almost as if somebody has spilled coffee on the slide.

Long before it landed in McKee’s lab at the Bedford VA Hospital, Hilgenberg’s brain had spent 16 years getting scrambled inside an NFL helmet. Its owner played linebacker for the Detroit Lions and the Minnesota Vikings in the ’60s and ’70s, and suffered for it later in life. Doctors believed ALS, known as Lou Gehrig’s disease, was the cause of Hilgenberg’s 2008 death. But McKee and her fellow researchers at the Boston University Center for the Study of Traumatic Encephalopathy, with which she is affiliated, now suspect that ALS was a misdiagnosis. Though Hilgenberg experienced the muscle weakness and atrophy consistent with ALS, McKee believes the true culprit was chronic traumatic encephalopathy, or CTE. Put simply, CTE results from too much banging of the head: Too much abnormal tau builds up, leading to too many dead brain cells, which can lead, finally, to a person’s inability to properly control his muscles. McKee and her colleagues speculate that even the oft-concussed Lou Gehrig could actually have suffered not from his namesake disease, but from CTE.

McKee slides another brain sample under the microscope, that of Lou Creekmur, who played offensive line for the Lions during the ’50s. Again, brown splotches all over, mottled like a smoker’s lungs. Even to someone who doesn’t know a hippocampus from a hippodrome, it’s clear that something is wrong here. Like Hilgenberg, Creekmur’s brain was battered throughout his 10-year NFL career. Later in life, he suffered memory loss, had difficulty focusing, and became prone to intense, angry outbursts. “He died in his eighties,” McKee says, “but he was severely demented.”

McKee inserts a final slide. This brain looks surprisingly normal. With its smooth, off-white surface, it’s the model of health. But as McKee pushes the slide forward, moving it to reveal the frontal cortex, the telltale brown marks start to appear, seeping out from the corners like tributaries feeding a river. “You see areas like this where it’s very distinctly abnormal,” she says. “The damage isn’t just restricted here; it’s spreading all the way to neighboring parts of the brain.” This brain, McKee says, did not belong to an NFL player. “This is a young kid.”