How is CTE diagnosed?

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Currently, the only way to diagnose CTE is after death through an autopsy and neuropathological examination of the brain. After putting special chemicals on the brain tissue that stain the abnormal tau protein, the neuropathologist examines the brain tissue under a microscope and looks for the telltale diagnostic findings of accumulation of tau protein around small blood vessels, preferentially in the depths of the cortical sulci (i.e., the valleys and crevices in the outer layer of the brain). They also determine whether the abnormal tau protein has spread to other areas of the brain, and they examine the degree to which there is atrophy of the brain and where that atrophy is. Neuropathologists use all of this information to determine if the person had CTE, in addition to determining the severity of the disease.