Wilma, the punch-drunk wife

 

Wilma is my nickname for the 76 year old women who was the subject of Dr. Roberts' paper on "Dementia in a punch-drunk wife." Her case stands alone with only one other paper published on possible CTE in a woman.

I have tried for the last two weeks to find Dr. Roberts, but he seems to have not published since 2002, when he was last in Scotland. I am still looking for him. And until I find him or one of the authors, my questions about Wilma will have to remain unanswered.  

"Dementia in a punch-drunk wife," The Lancet, April 14, 1990

 

It is interesting that in the article written in 1990, the authors chose to use the term, "punch drunk syndrome" (dementia pugilistica) which was coined by Harrison Martland, in 1928. The term chronic traumatic encephalopathy was coined by Bowman & Blau (1940) when they described the case of a 28-year-old professional boxer in their chapter “Psychotic States Following Head and Brain Injury in Adults and Children” (see Brock 1940).

In the paper, Dementia in a Punch-Drunk Wife, authors seem to be looking for a link for dementia caused by trauma outside boxing but... "Such a link between head injury and dementia in former professional boxers is firmly established but the possibility of a similar sequence outside the boxing rind is more difficult to establish." 

The 76 year old women in this case had a history of violence abuse by her husband and had become "demented over the past few years."

After her death, "necropsy revealed abnormal thickening of the ears, resembling the 'cauliflower ears' of pugilists." This was a key finding as it provided a link to the boxers.

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The appearance of this brain of this repeatedly battered woman resembled that seen in "dementia pugilistica" which had been found in boxers.

"The important point to establish is whether the repeated head trauma -- which was supported by the finding of the cauliflower ears -- was causally connected to the neuropathological degeneration." 

"This patient's frontal cortex had hardly any neuritic component yet had tangles and large numbers of diffuse plaques."

 

 

Quote from the photo: "Typical senile plaques conspicuous by their absence."

 

 

 

 

 

 

The authors conclude that "To our knowledge large numbers of cortical plaques with the same morphological and immunological profile have only been reported in dementia pugilistica, suggesting that trauma was indeed a significant contributory factor in this case."

"Our case helps to fill the gap in the evidence for the concept that head injury can be followed by Alzheimer-type degeneration."

I am still working to track down the authors of this paper and will post any more information I can find.

Please post questions and comments below.