CTE in Hockey

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rainier2
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Re: CTE in Hockey

Post by rainier2 » Tue Nov 12, 2019 7:54 pm

A Preliminary Study of Early-Onset Dementia of Former Professional Football and Hockey Players

Participants: Twenty-two retired professional hockey and football athletes (average age 56 years) and 21 age-matched noncontact sport athlete controls.

Conclusion: None of the retired contact sport athletes qualified as having early-onset dementia consistent with chronic traumatic encephalopathy. There were no remarkable differences in imaging, cognition, behavior, or executive function from noncontact sport athletes. The results underscore an apparent disconnect between public perceptions and evidence-based conclusions about the inevitability of chronic traumatic encephalopathy and the potential neurodegenerative effect on former athletes from contact sports.

https://journals.lww.com/headtraumareha ... _of.9.aspx

rainier2
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Re: CTE in Hockey

Post by rainier2 » Tue Nov 12, 2019 7:58 pm

No Linear Association Between Number of Concussions or Years Played and Cognitive Outcomes in Retired NFL Players.

METHOD: Thirty-five retired NFL players over the age of 50 who had sustained at least one concussion completed a clinical interview and brief neuropsychological battery. Correlational analyses were conducted between exposure variables [number of total concussions, concussions with loss of consciousness (LOC), and years played] and cognitive performance as characterized by cognitive composite scores based on performance on neuropsychological measures (attention/processing speed, language, memory, and overall composite scores).

CONCLUSIONS: We did not find a significant linear association between cognitive outcomes and either number of total concussions, concussions with LOC, or years played in the NFL. These findings do not support a dose-response relationship between sports-related exposure to head impacts and cognitive outcomes later in life. Rather, the findings suggest that cognitive difficulties experienced by some retired players later in life are not directly linearly associated with quantified exposure to head impacts sustained throughout a football career, but related to factors or combinations of factors that have yet to be elucidated.

https://www.ncbi.nlm.nih.gov/pubmed/30844072 (March 2019)

rainier2
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Re: CTE in Hockey

Post by rainier2 » Tue Nov 12, 2019 8:03 pm

Is football bad for the brain? We know little about the long-term effects of concussions

by Munro Cullum, Ph.D., a neuropsychologist at UT Southwestern Medical Center’s Peter O’Donnell Jr. Brain Institute in Dallas.

"As a neuropsychologist, I applaud the increased attention that has led to improved protocols for diagnosing sports-related concussions and removing athletes from play until they have fully recovered. But I worry that the pendulum has swung too far. The reality is that we still don’t know who is most likely to suffer a concussion, who will take longer to recover, how anatomic or genetic differences influence concussions, and who may be at risk of prolonged symptoms or developing cognitive problems later in life."

"Rather than allowing fear to deprive children of the benefits of sports participation, let’s allow science to define the risks and help us make informed decisions."

https://www.statnews.com/2019/09/27/con ... m-effects/ (Sept. 2019)

greybeard58
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CTE Risk More Than Doubles after Just Three Years of Playing Football, says new study

Post by greybeard58 » Wed Nov 13, 2019 11:21 am

CTE Risk More Than Doubles after Just Three Years of Playing Football, says new study

For every year of absorbing the pounding and repeated head collisions that come with playing American tackle football, a person’s risk of developing chronic traumatic encephalopathy (CTE), a devastating neurodegenerative disease, increases by 30 percent. And for every 2.6 years of play, the risk of developing CTE doubles. These new findings from an analysis of 266 deceased former amateur and professional football players—reported in Annals of Neurology by a team of researchers from the Boston University CTE Center—are the first to quantify the strength of the link between playing tackle football and developing CTE.

In a critical distinction between many previous CTE studies, the analysis included dozens of brains of former football players who did not have CTE. That sizable control group provided enough data for the researchers to be confident in their discovery that there is a strong relationship between CTE risk and the number of years a person plays football.

“This study is a testament to the hundreds of families who have donated their loved one’s brain…. It is only because of this support that we can confidently estimate the strength of the relationship between duration of [football] play and risk of CTE,” says the study’s corresponding author Ann McKee, a William Fairfield Warren Distinguished Professor and a School of Medicine professor, director of the BU CTE Center, and chief of neuropathology at VA Boston Healthcare System.

The large number of brain donations has provided the researchers with a big enough sample size (the CTE Center has amassed about 700 brains in total), that they can draw statistically relevant conclusions from their analyses.

“While we don’t yet know the absolute risk of developing CTE among American football players, we now can quantify that each year of play increases the odds of developing CTE by 30 percent,” says lead author Jesse Mez, a MED assistant professor, director of BU’s Alzheimer’s Disease Center Clinical Core, and a CTE Center researcher. “We hope that these findings will guide players, family members, and physicians in making informed decisions regarding play.”

As part of their analysis, the researchers also looked at other potential variables, including the total number of concussions, football positions played, a person’s age at first exposure to tackle football, their participation in other contact sports, their race, and the presence of other diseases, to see whether those factors had any influence on a person’s CTE risk, or if they were diagnosed with CTE, the severity of their CTE symptoms. They found no associations between these other variables and CTE risk or severity.

But the researchers did find that among players with a CTE diagnosis, their odds of developing severe symptoms of the disease doubled for every additional 5.3 years of football played. Those who played tackle football fewer than 4.5 years were 10 times less likely to develop CTE than those who played longer, although several men who played four years or fewer were diagnosed with CTE, including three whose only contact sport was football. Those who sustained the longest careers, playing more than 14.5 years, were 10 times more likely to develop CTE than those who played fewer years. But the researchers noted that several players with football careers longer than 15 years did not have evidence of CTE.

The average length of players’ careers in the National Football League is 3.3 years. But the premature and sudden retirements of a number of stars in the league, including Indianapolis Colts quarterback Andrew Luck, Detroit Lions receiver Calvin Johnson, and New England Patriots tight end Rob Gronkowski, have put renewed attention on the toll the game takes on players’ bodies.

The BU team drew their findings from analyzing the brains of 223 football players with CTE, and 43 without, from the brain banks at the Veterans Affairs-Boston University-Concussion Legacy Foundation and the Framingham Heart Study, both of which are directed by McKee. Family members of the deceased provided information about the amount of time that the brain donors spent playing football or other contact sports while they were alive. For former professional players, an online database also was consulted. All of the brains underwent a complete neuropathological evaluation—the researchers were not made aware of the clinical history of any of the donors before examination—and CTE diagnoses were made using well-established criteria.

A major concern of doing CTE research utilizing brain banks is that brain donors—who may pledge their brain tissue based on neurological symptoms they’ve experienced during life—may not be representative of the general population. These factors may bias the relationships being investigated by researchers. But McKee, Mez, and their collaborators show in this latest study that the strength of the relationship between CTE and years of football played remained consistent even after they factored in these potentially biasing factors.

Although CTE currently can only be diagnosed after death, Mez says, “these findings move us closer to diagnosing CTE in life, which is critical for testing potential therapies and for guiding clinical care.”

This study was funded by the National Institutes of Health, the Department of Defense, the Department of Veterans Affairs, the Alzheimer’s Association, the National Operating Committee on Standards for Athletic Equipment, the Nick & Lynn Buoniconti CTE Research Fund, the Concussion Legacy Foundation, the Andlinger Family Foundation, WWE, and the National Football League.

CTE Risk More Than Doubles after Just Three Years of Playing Football
BU researchers discover a strong link between time of football play and rising chance of getting the disease
Read more: https://www.bu.edu/articles/2019/cte-football/

greybeard58
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Pain, agony and years of duress: how hockey families handle chronic brain injuries

Post by greybeard58 » Thu Nov 28, 2019 10:55 am

Pain, agony and years of duress: how hockey families handle chronic brain injuries

Jennifer Belak Liang remembers her car phone ringing as she was picking up her daughters Alex and Andie from school one day in August 2011. It was the agent for her husband, hockey player Wade Belak.

On speaker phone, the agent asked her if she had spoken to her husband that day.

She hadn't. It was the second phone call she received asking that question and it filled her with dread.

"Wade is really hurt," the agent said.

"It was awful. I was called by multiple friends … they knew before I knew. But they didn't know what to say," Belak Liang said of the day she lost her husband to suicide.

Belak's suicide was the third death in a cluster of tragic and sudden deaths of NHL enforcers, including Derek Boogaard, 28, and Rick Rypien, 27. All had been tasked with fighting on ice and all suffered multiple hits to the head. There have been other deaths of players since, including Steve Montador and Todd Ewen.

Now, the wives of some of the retired hockey enforcers are in their own fight, taking on the NHL and commissioner Gary Bettman. They want the league to acknowledge there's a link between fights and head injuries on the ice and long-term effects like degenerative brain disease. They also want more support for families struggling with symptoms of traumatic brain injury.

"My husband had CTE. He was showing signs of CTE. He took his own life," said Belak Liang. "It's going to be many more... It's [an] injustice to everyone else out there, I think, for them not to admit that this can happen."

Wade Belak had recently retired from his 14-year career with the National Hockey League and was in Toronto in the summer of 2011 rehearsing for the show Battle of the Blades — the CBC reality show that pairs hockey players with figure skaters. At approximately 1:30 p.m. on Aug. 31, he ended his life.

After the loss of her husband, Jennifer Belak Liang struggled with feelings of isolation and guilt.

"I was drowning, blaming myself," she said in an interview with The Fifth Estate.

At the time, she knew little of chronic traumatic encephalopathy (CTE), a progressive degenerative disease. Her husband had asked that in the event of his death, his brain be tested for the disease. She fulfilled his wish, and he was diagnosed with CTE.

Since the loss of her husband, Belak Liang, who has since remarried, tries to offer support to others facing tragic loss of loved ones.

'Knew his role'

As an NHL enforcer who played 14 seasons in the NHL, Belak "knew his role," said Belak Liang. "He didn't love it, but he was fine with it [because] he wanted to stay within the NHL and have his career.

"He told me: 'I can't stay here unless I fight.' "

While many hockey players can make millions during their career, brain trauma and concussions can take a toll, especially for those who played the role of an enforcer — a role now being phased out.

It was during her husband's last years with the Nashville Predators that Belak Liang noticed a shift in his behavior.

"It started about five years before he passed. He just got really introverted, really quiet at home. When the kids were screeching or making noises, I could see him not able to handle it, which was not like him."

About eight months before he died, Belak noticed a decline in her husband's memory. He'd use his phone to help remember daily tasks, including taking pictures of groceries he had to buy.

'Through sickness and in health'

Many experts say concussions can often lead to a cycle of substance abuse, depression, memory loss, even suicide.

Daniel Carcillo, 35, from King City, Ont., has won two Stanley Cups with the Chicago Blackhawks, and was known as Car Bomb for his reckless fighting style on ice. He now battles depression and suicidal thoughts.

Carcillo said his wife, Ela Bulawa, has been burdened. "But I think that's what marriage and loving somebody is all about, right? Through sickness and in health."

While he was in his final NHL season with the Chicago Blackhawks in 2015, Carcillo suffered great personal loss: the passing of his grandfather, as well as his best friend and teammate, Steve Montador, who was found to have CTE.

Carcillo, who had seven concussions during his NHL career, wonders if he could become another statistic. "Wade had CTE. Are these reaffirmations that I'm going to have CTE?... "There's a pretty good chance."

Recognizing the signs

Once retired, players can often feel abandoned and without support. Carcillo said he has felt that way. But he's taken steps to heal: functional neurology therapy, acupuncture, proper nutrition and diet. He speaks publicly, often on social media, about traumatic brain injury and the impact it can have.

"I'm very, very proud of Daniel, from where he has been, and where he is now," Bulawa said.

They have started a foundation called Chapter 5, which aims to provide support to retired players and their families, especially players who are suffering post-concussion syndrome, anxiety and depression.

"They put their whole lives into playing hockey and being the best of the best. And once it's over, then what?" said Bulawa. "It shouldn't just be,'Oh, that's it, sorry guys. See ya later.' "

Carcillo and Bulawa have learned to recognize signs of his depression returning, for example sleeping in, impulse control issues, loss of appetite and withdrawal from friends and family.

Blurry vision and headaches

Todd Ewen played hockey in the era when even after getting rocked on the ice, players were sent back out again. Both he and his wife, Kelli, believed he experienced head trauma because he had symptoms: blurry vision, headaches and sleeplessness.

After playing 11 seasons in the NHL, Todd Ewen retired in 1997. He became a real estate agent, was a musician, patented several inventions and coached the St. Louis University Billikens.

But Ewen was struggling. He became aggressive with Kelli. Depression, memory loss and confusion plagued him.

By 2013, he gave up coaching because he couldn't remember plays and was missing practices.

"We didn't know who we had. One day we had the sad Todd, the mad Todd, the angry Todd. We had no idea what was going on. This man suffered for years like this, our family suffered for years like this," his wife said.

They wondered if he could have Alzeimher's or Parkinson's disease, but with the loss of Rypien, Boogaard and Belak in 2011, Ewen began to wonder if he could have CTE. He told Kelli one day that he didn't want to be a burden. At the time, she did not realize the weight of his words.

On Sept. 19, 2015, Kelli Ewen found her husband in the basement of their home near St. Louis. He was 49 when he killed himself.

The Ewen family was contacted by the Canadian Concussion Centre in Toronto asking to study Todd's brain.

"I knew something was wrong. And I thought maybe this is the answer. I read the articles about [CTE]. I could just check off the boxes, just one after another. And I thought this has to be it."

But neuropathologist Dr. Lili-Naz Hazrati at the centre told Kelli her husband did not have CTE. She was devastated and desperate for an explanation and said she asked the doctor to retest his brain, but Hazrati declined.

Class action lawsuit

In 2018, a class action lawsuit between more than 300 retired players and the NHL was settled. Players had accused the league of failing to protect them from head injuries or warn them of the risks involved with playing.

Ewen's negative CTE results were used as an example in the lawsuit of how media hype could lead a person to kill themselves because of fear of having CTE.

Bettman wrote: "This, sadly, is precisely the type of tragedy that can result when plaintiffs' lawyers and their media consultants jump ahead of the medical community and assert, without reliable scientific support, that there is a causal link between concussions and CTE."

Kelli Ewen said she was was extremely hurt, and believed they were using her husband for the benefit of the lawsuit.

The NHL announced an $18.9-million US settlement — $22,000 US per player and medical expense coverage up to $75,000 per person. However, there was no acknowledgement of liability for the players' assertions.

Carcillo refused to participate in the settlement.

Another test

Kelli Ewen couldn't live with the results from the Canadian Concussion Centre. She arranged to have samples of her husband's brain sent to Dr. Ann McKee, a neuropathologist and director of Boston University's CTE Center.

Her research, much of which has involved professional athletes, focuses on the long-term effects of all kinds of brain injury, which can include CTE. Currently, CTE can only be diagnosed with an autopsy.

While there is no known treatment, the hope is research from Boston University's brain bank will one day allow the detection of the disease in life, "while there's still a chance to do something about it," McKee said.

In late 2018, McKee revealed her own conclusions to Kelli Ewen, stating her instincts were correct: her husband did, in fact, have CTE.

"[Gary Bettman] still stands by the [original] findings, which I find mind-boggling," Kelli Ewen said.

'It's not about money'

Kelli Ewen filed a lawsuit against the NHL on April 30, 2019, challenging the league's dismissal of a link between hits to the head during hockey games and CTE . She wants to bring awareness to concussions and CTE and the suffering families go through when they don't understand the symptoms they're seeing with their husbands.

"It's not about money, you know? It's about the pain, the agony, the years of duress," she said.

"I feel like it's the NHL's responsibility to stand up and take care of these players that this great game of hockey was built on; these fighters that gave, essentially, their lives for the NHL. And it's time for them to step up and admit and help them get the help they need."

The day after Kelli Ewen's lawsuit was filed, Bettman appeared before a Commons subcommittee in Ottawa regarding sports-related concussions and safety.

Bettman questioned any direct link between multiple hockey concussions and CTE, saying "in short, I don't believe based on everything I've been told — and if anybody has information to the contrary, we'd be happy to hear it — other than some anecdotal evidence, there has not been that conclusive link."

"Our players like the way the NHL game is played and understand the implications of playing a physical contact sport at the highest professional level in the world," he said.

"At the end of the day we view ourselves as a family, and our resources are available to the members of our family."

Jennifer Belak Liang, Kelli Ewen and the Carcillo family would disagree.

"It's crazy to me that they won't admit anything. It's sad," Belak Liang said.

"At least admit it's real," said Ewen. "That would go a long way with a lot of the families."

The Fifth Estate requested an interview with Bettman to address the wives' concerns, but the only response was: "Thank you for your inquiry. We will not be participating."

At a sports conference in Toronto last week, The Fifth Estate's Bob McKeown approached Bettman. All he would say was: "How are you? Nice to see you. I gotta go."

Pain, agony and 'years of duress': How hockey wives are fighting back over players' chronic brain injuries
Women also want more support for families struggling with symptoms
Read more: https://www.cbc.ca/news/canada/hockey-p ... -1.5370444

greybeard58
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"Here’s the documentary that Gary Bettman doesn’t want you to see"

Post by greybeard58 » Tue Dec 03, 2019 12:15 pm

"Here’s the documentary that Gary Bettman doesn’t want you to see"

Sports Agent/Lawyer Allan Walsh: "Here’s the documentary by the Fifth Estate that Gary Bettman doesn’t want you to see. This is an honest, in-depth look at NHL players with traumatic brain injuries and the impact on their families. A group of wives are fighting back.”

Behind the facade of glamour and wealth, the wives of some retired hockey enforcers are in their own fierce fight. They want the NHL to acknowledge that there's a link between fights, and head injuries on the ice and long-term effects like degenerative brain disease. Women like Jennifer Belak and Kelli Ewen whose husbands Wade Belak and Todd Ewen took their own lives are part of that fight but so too is Ela Carcillo. She is married to recently retired player Daniel Carcillo who says he wonders if he will become one of the sad statistics.

Hockey Fight: Wives Reveal The Cost of Concussions - The Fifth Estate
Watch at: https://www.youtube.com/watch?time_cont ... e=emb_logo

greybeard58
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Joined: Sat Aug 21, 2004 11:40 pm

Minnesota judge rules former 'Miracle on Ice' star mentally ill and dangerous

Post by greybeard58 » Wed Dec 04, 2019 11:45 pm

Minnesota judge rules former 'Miracle on Ice' star mentally ill and dangerous
Former U.S. Olympic hockey player Mark Pavelich was ordered committed to a secure treatment facility.
By Pam Louwagie Star Tribune DECEMBER 4, 2019 — 9:30PM

A Minnesota district judge ruled Wednesday that former “Miracle on Ice” U.S. Olympic hockey player Mark Pavelich is mentally ill and dangerous and ordered him committed to a secure treatment facility.

Pavelich, 61, of Lutsen, Minn., will get another hearing in February to determine whether he should remain committed for an indeterminate period of time.

Pavelich faced criminal charges that he beat a friend with a metal pole in August after a day of fishing. Charging documents alleged that he had accused the friend of “spiking his beer” and that his friend suffered cracked ribs, a bruised kidney and a fractured vertebra, as well as bruises.

Judge Michael Cuzzo found Pavelich incompetent to stand trial, however, concluding based on an expert report that Pavelich was “incapable of participating in the defense due to mental illness or deficiency.” The criminal case was put on hold while the state moved to civilly commit him to treatment.

Two clinical psychologists who examined the former hockey star found Pavelich to have post-traumatic stress disorder, as well as other conditions, according to Cuzzo’s order. Both found that he lacked insight into his mental illness and opposed treatment. Both considered him to be mentally ill and dangerous.

According to the order, psychologist Chris Bowerman found Pavelich to have delusions and paranoia, including a delusion that family, friends and neighbors tried to poison him. Bowerman noted that Pavelich’s responses escalated from damaging property to inflicting harm on another person.

Psychologist Jacqueline Buffington found Pavelich suffers from “mild neurocognitive disorder due to traumatic brain injury with behavioral disturbance (psychotic symptoms, aggression),” and opined that his condition is likely related to head injuries suffered over his lifetime.

Buffington also found that Pavelich sometimes “responded irrelevantly” to questions and struggled to express himself. She said it reflects a “mild anomic aphasia,” or communication difficulty that “usually results from damage to the brain,” according to the order.
The findings revealed in the court documents reflect what some of Pavelich’s family members have said in the past. They are convinced that Pavelich suffers from CTE, or chronic traumatic encephalopathy, after repeated concussions and blows while playing in the NHL. They said they started seeing changes in him a few years ago and had tried to get help for him, but that he had refused.

His sister, Jean Gevik, has called his case “heartbreaking.”

“He’s been an amazing brother. Fun. Loving,” she has said. “This has been a total change.”

The NHL has faced criticism for its handling of head injuries despite a long list of rules, studies and league-player committees focused on enhancing player safety. The league reached a court settlement last year with hundreds of retired players who claimed harm from head injuries while playing, but the NHL admitted no fault or wrongdoing. Pavelich did not make a claim, his sister has said.

Pavelich assisted on Mike Eruzione’s winning goal in a stunning upset of the heavily favored Soviet Union in their medal-round game of the 1980 Olympic hockey tournament, referred to as the “Miracle on Ice.” Team USA went on to defeat Finland to win the gold.

Pavelich played with the New York Rangers for five seasons and briefly joined the Minnesota North Stars and San Jose Sharks. Out of the game since 1992, he has lived quietly in Cook County.

His wife, Kara, died in an accidental fall from a balcony at their home in 2012, and several years later, Pavelich sold his gold medal for more than $250,000 in an auction.

Pam Louwagie is a regional reporter and Duluth Bureau Chief for the Star Tribune. She previously covered courts and legal affairs and was on the newspaper's investigative team. She now writes frequently about a variety of topics in northeast Minnesota and around the state and region.

pam.louwagie@startribune.com 612-673-7102 pamlouwagie

Minnesota judge rules former 'Miracle on Ice' star mentally ill and dangerous. http://strib.mn/38535ag

O-townClown
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Re: CTE in Hockey

Post by O-townClown » Thu Dec 05, 2019 6:34 pm

so sad for anyone to go through
Be kind. Rewind.

greybeard58
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Tau pathology in the medial temporal lobe of athletes with chronic traumatic encephalopathy

Post by greybeard58 » Sat Jan 04, 2020 12:49 am

Tau pathology in the medial temporal lobe of athletes with chronic traumatic encephalopathy: a chronic effects of neurotrauma consortium study | Acta Neuropathologica Communications | Full Text

https://actaneurocomms.biomedcentral.co ... 019-0861-9

greybeard58
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A broken star: Family hopes Olympic hockey player Mark Pavelich's story helps others

Post by greybeard58 » Sun Feb 09, 2020 3:53 pm

Broken Star

He was once an American sports hero, a high-flying playmaker from Minnesota’s Iron Range who competed with the best hockey players in the world.

Forty years ago this month, Mark Pavelich was thrust into the international spotlight when he passed the puck to a U.S. Olympic teammate for the game-winning goal over the powerful Soviet Union in an epic matchup forever remembered as the “Miracle on Ice.” Two days later, the U.S. won gold.

But now, on a gray wintry day in the Cook County courthouse, Pavelich’s glory days were a distant memory.

His once-thick brown hair was tousled and silver, the star-spangled uniform of the 1980 Olympic team replaced by a faded striped jailhouse jumper. Charged with beating a neighbor with a metal pole, the 61-year-old sat handcuffed before a judge as he listened to psychologists opine that he was so mentally ill he couldn’t be trusted with his own safety.

It was a heartbreaking fall for his family and friends to see. This wasn’t the kind, generous introvert they knew, the quiet, solitary man who wasn’t apt to pick a fight. This was a Mark Pavelich they didn’t recognize — someone who, in recent years, had started to act confused, paranoid and borderline threatening. And it left them wondering: Was the game that had given Pavelich so much purpose and joy through the years also destroying him?

Too many hits, too many blows to the head, too many collisions while battling for loose pucks on rinks from Eveleth to New York City have led Pavelich’s family to believe he suffers from chronic traumatic encephalopathy (CTE), a degenerative disease that can manifest in violence, impulsiveness and paranoia.

This spring, months after sending Pavelich to a secure state facility for mental health treatment, a judge is expected to decide whether his condition has improved to the point where he is no longer deemed dangerous.

Pavelich, speaking by phone from the facility, said recently that he felt he shouldn’t grant an interview while the determination is pending. “It’s just too tricky here,” he said.

In the meantime, his family is working to call attention to his plight and that of other athletes forever damaged by the games they played.

“Maybe his story is supposed to help a lot of people,” said Jean Gevik, Pavelich’s sister. “That’s what I’m hoping.”

Dedication

Mark Pavelich declared as a young boy that he was going to be an Olympian.

“It wasn’t a question,” Gevik said. “He was going to make it work.”

Growing up in Eveleth, where hockey reigns supreme, Pavelich skated on the lake in front of his house as well as at a rink a quarter mile away. He rose before dawn to practice, and he often stayed late after other players left to work on stickhandling drills or to practice passing the puck from skate to stick. On some school nights, his parents practically had to drag him home.

A big Bobby Orr fan, he and teammate Ronn Tomassoni persuaded the manager at the U.S. Hockey Hall of Fame in Eveleth to let them watch hours of NHL highlights, both boys mesmerized by the smooth-skating Boston Bruins defenseman.

What Pavelich lacked in stature, at 5 feet 8 inches tall, he worked to make up with finesse, speed and grit. Though he didn’t pick fights on the ice, friends said, he never shied away from action. “A lot of guys don’t want to be the first person in the corner because you know you’re going to get hit,” Tomassoni said. But Pavelich “wasn’t going to shy away from the physicality of the game.”

Teammates saw early on that Pavelich was a cut above. “He just skated so smooth. His skates never left the ice,” said Peter Gilliam, a high school teammate. “He just glided.”

And yet, Gilliam and others said, Pavelich was an unselfish player, a center with a sixth sense for finding open wingers for a quick pass and a shot on goal.

“He would have an empty net after beating two defensemen … and give me the goal,” Gilliam said. “People … need to know how gentle Mark was.”

Pavelich’s life was jolted at age 18 when he was involved in a hunting accident that killed his friend. Ricky Holgers, 15, was hit by a ricocheting bullet, his brother Mike Holgers recalled. Pavelich had pulled the trigger. He raced about a mile through the woods to call an ambulance, then ran back to help his brother carry Holgers out, Gevik said. Later, he disappeared into the forest, distraught. A search party found him curled up by a tree, covered in blood, Gevik said.

After that, nobody talked much about it, Gevik said.

“You didn’t know how to deal with tragedy back then,” she said. “You just kind of brushed it under the rug and hoped it went away.”

Holgers’ family remained friends with Pavelich. And Pavelich forged ahead.

He earned a spot on the University of Minnesota Duluth team, where he won All-America honors before going on to star for the 1980 U.S. Olympic team under coach Herb Brooks.

NHL teams later shied away from Pavelich, his small size a big factor. So he learned to fly an airplane and played guitar in a band, often covering the Rolling Stones. He played hockey in Switzerland for a while.

Then Brooks became head coach of the New York Rangers and gave Pavelich a shot at the NHL.

“I don’t care how big or small he is, he can play,” Brooks was quoted as saying in Pavelich’s second year with the Rangers.

Pavelich scored 99 goals in his first three of five seasons with the team. He played in more than 350 NHL games in a career that spanned seven seasons.

“He was knocked down often,” a Star Tribune article said at the time, but “he always got up.”

Pavelich played hockey because he loved the game, not because he was seeking glory, friends, family and former teammates said.

He was quiet around strangers but opened up to those close to him. He was generous with his time and the good fortune that hockey and real estate development brought him, sending signed memorabilia to the children of friends and relatives, buying bonds for nieces and nephews, and showing up at friends’ fundraisers.

He was playful, too, friends and family said. He and a brother pranked his sisters on one of their frequent trips to the Boundary Waters by rustling in the woods to scare them into thinking there was a bear in camp. Afterward, he cracked up laughing.

“When you got to know him well and he felt that he knew you well … it would be a lot of fun,” said John Harrington, a fellow Iron Ranger and college and Olympic teammate.

Though Pavelich was described in media reports as a recluse in his post-hockey life, those close to him say he simply preferred fishing and hunting and spending time outdoors with his dogs.

“He’s always shunned the spotlight, and he’s had some pretty big spotlights on him. But he’s never wanted that,” Tomassoni said. “I think a lot of people misconstrued that shyness maybe for arrogance in some ways … he’s the furthest thing from arrogant.”

Confusion and contradiction

Relatives started noticing changes in Pavelich after his wife — a gifted pianist and painter — died in what was deemed a tragic accident in 2012. Kara Pavelich fell about 15 feet from a small bedroom balcony onto rocks on the couple’s property in Lutsen, apparently trying to get cellphone reception while Mark was taking a nap. He told responders that he woke up and found her on the ground.

“They were like peas and carrots,” Gevik said. “He was lost.”

Pavelich’s brother-in-law, Mark DeCenzo, remembers loading some of Kara’s paintings into his car to take to Pavelich’s mother’s house, as he said Pavelich had requested. A few years later, Pavelich questioned him about it, he said.

“He thought I was stealing stuff,” DeCenzo said. “That was probably the first time I saw something that made me wonder what was going on. … He lost sight of what transpired.”

Gevik remembers being frustrated by her brother’s puzzling inconsistencies, too.

Mark had decided to sell one of Kara’s paintings that had been hanging in an exhibit, saying he couldn’t bear to look at it, Gevik recalled. Thinking he might change his mind, Gevik and her husband planned to buy it so that Mark could have it later, she said.

“Pretty soon it was ‘Jean, I didn’t want to sell that,’ ” Gevik recalled.

He had been similarly perplexing when he decided to sell his Olympic gold medal and other memorabilia in 2014, Gevik said. He wanted to pay off the mortgage for his daughter’s house, he told the family, but kept changing his mind on how much he wanted, to the point where the auctioneer called Gevik.

“What I saw is a lot of confusion and a lot of contradiction,” Gevik said.

A psychology major, Gevik talked with her brother about getting help, she said, but he didn’t want to hear it. He grew angry instead. She ended up going to counseling, she said, trying to figure out what to do.

It was her counselor, she said, who first suggested that Mark might have CTE.

Growing concern

The calls came into the sheriff’s office sporadically over a few years. Mark Pavelich was acting strangely, and his neighbors and family members who called said they were worried. They wanted law enforcement to be aware of what was happening.

Pavelich had accused a neighbor of dumping sludge into his car fuel tank, one caller said. Another believed Pavelich had taken a sledgehammer to a neighbor’s boat.

One relative who telephoned said Pavelich was convinced that cookies from a neighbor were poisonous, and he was keeping them in his freezer as proof.

Then, last summer, a Lutsen resident called to report that he had been attacked with a metal pole and identified Pavelich as the aggressor.

Pavelich was booked into the Cook County jail on assault and weapons charges. A criminal complaint described Pavelich as accusing the neighbor of spiking his beer. The victim suffered two cracked ribs, a bruised kidney and a fractured vertebra, the complaint said.

In October, Pavelich was found incompetent to stand trial on the charges. Later, a psychologist who examined him for civil commitment proceedings determined that he suffered from post-traumatic stress disorder as well as mild neurocognitive disorder due to traumatic brain injury, saying his condition is “likely related” to the head injuries sustained over his lifetime.

DeCenzo and other family members can’t help but wonder whether the trauma of losing his wife so suddenly — and grieving and living alone after that — made his underlying illness unmanageable.

“My guess is … he was probably fighting it and she was probably the stabilizer,” DeCenzo said. “Somebody at home to keep you grounded.”

Diagnosis tricky

That is a possible scenario, said Dr. Bennet Omalu, a pathologist who has done research on CTE but was not familiar with the details of the Pavelich case.

“With all types of diseases, when you have social support, your disease is better managed,” Omalu said, adding that social stressors “are more likely to aggravate your underlying brain disease.”

While CTE can be confirmed only in an autopsy, scientists are working on a test to detect proteins associated with the disease in living people.

But doctors in some cases are now making a presumptive diagnosis of CTE, as they do in other types of dementia, Omalu said, relying on the standard of a “reasonable degree of certainty — meaning more likely than not.”

CTE is not the only type of brain damage an athlete can suffer, Omalu said. And if someone’s family has a history of mental illness, high-impact sports can increase the likelihood of manifesting mental illness, he said.

“Maybe with treatment … medication, his symptoms can subside,” Omalu said.

Pavelich’s family is hoping he will be released from the state facility where he has been housed since a judge found him “mentally ill and dangerous” in December.

A hearing to make a final determination on whether he should remain civilly committed indefinitely is expected to be held this spring.

In the meantime, some former NHL players are working with Pavelich to establish a therapeutic retreat ranch where players, their families and others struggling with mental illness and brain disease can go for counseling, animal therapy and other programs, as well as supporting research on CTE. They have started a fundraising campaign on GoFundMe.

“You’re a good person your whole life …” Gevik said, her voice trailing off as she teared up thinking about what’s happened to her brother.

Now, she said, she just hopes something good can come from it.

“I told him, ‘We can help a lot of people this way.’ ”

A broken star: Family hopes Olympic hockey player Mark Pavelich's story helps others
Read more: http://www.startribune.com/a-broken-sta ... 567696722/

Jack O'Callahan, left, and Mark Pavelich of the 1980 U.S. ice hockey team talked during the "Relive the Miracle" reunion at Herb Brooks Arena on Saturday, Feb. 21, 2015, in Lake Placid, N.Y.
— Mike Groll - Associated Pres

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