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A Nightmare Roller-Coaster for Karageorge’s Family

2016 June 23

The New York Times recently published a gut-wrenching story on the downward spiral and subsequent tragic end to a young athlete’s life. Kosta Karageorge wrestled and played football at Ohio State University. He reportedly suffered numerous concussions, in addition to an immeasurable number of sub-concussions.

Karageorge committed suicide in November 2014. His body was found in a dumpster a few days later with a bullet wound to his head.


According to reports, the coroner’s office sent Karageorge’s brain to an Ohio State University pathologist, Dr. Norman Lehman, for further examination. Following an apparent examination, Dr. Norman publicly concluded that Karageorge “did not have CTE.”

When this report was released, I was suspect of the conclusion, especially in light of the fact that Dr. Lehman does not appear to have any expertise in the examination or diagnosis of neurodegenerative diseases, including CTE. Instead, while admirable, his specialty appears to be geared towards “cell cycle” and cancer.

Fortunately, the family—or through the advice of others—sought a second opinion.

The godmother of CTE, Dr. Ann McKee, analyzed Karageorge’s brain and determined that he had a history of traumatic brain injuries (traces of microhemorrhaging in the prefrontal cortex) and Stage 1 CTE.

This was an explanation the Karageorges were desperately searching for: “they interpreted the report as an explanation for their son’s erratic behavior,” according to the New York Times. Unfortunately, the Karageorges were forced to suffer through a roller-coaster of emotions before they received the results—all of which could and should have been avoided had the appropriate person analyzed Karageorge’s brain ab initio.

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Based on the reports, Karageorge’s issues were multi-factorial, including a history of mental-health problems and sport-related traumatic brain injuries, which are often a recipe for disaster. But several important lessons can be learned from Karageorge’s death.

First, athlete mental-health and well-being must be a primary focus on all campuses. Although the NCAA recently published its first “Mental Health Best Practices,” it is doubtful that a large percentage of member universities have actually implemented these programs. Of course, as history has shown, this is expected when the NCAA’s laissez-faire approach merely sounds in “recommendations” as opposed to mandates.

Second, to avoid another botched CTE examination by a seemingly unqualified pathologist, the NCAA and member institutions should take affirmative action to implement a system whereby they coordinate with family members of the decedent and provide guidance—or in the words of the NCAA, “recommendations”—on the appropriate individual or institution that should evaluate a loved one’s brain for CTE. This will ensure that another family is not subjected to a ricochet of emotions regarding the results of a CTE analysis, while also helping to advance the science.

And while numerous other lessons can be learned, Karageorge’s death and early-stage diagnosis of CTE is yet another stark reminder that young athletes are being subjected to repetitive brain trauma and therefore stakeholders must take immediate action to reduce this needless trauma. That is why common-sense approaches like limiting contact practices and promoting flag football should be implemented post-haste.

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