It seemed that the name of Aaron Hernandez, a famous American football player who died by suicide, would be mentioned only in the context of a cheap sensation. The 27-year-old’s brain dissection, however, produced some astonishing findings, of great importance to science and perhaps not less to sport.
The brain arrived in April, delivered unceremoniously to the basement of the hospital, like any other such organ. Yet this particular one stood out – not that it was more important; it just belonged to someone famous. Therefore, it was sent for testing to a laboratory outside the city, and not to one of the Boston centers, where such analyzes are most often commissioned, hoping for more discreet conditions. In addition, instead of routinely carrying it through the service entrance, the brain was transported through a system of underground tunnels. He was given a nickname and only three people were able to identify him correctly afterwards. In other words, the brain ended up on the dissection table, detached from its past and from the reputation of the man it once belonged to. Dark details of how this man first gained fame and then fell, speculation about what went wrong, debate on justice – all such matters are left to others to judge.
Within normal limits
Here we only had a brain, neither large nor small, not looking distorted or unusual, just elongated gelatinous coils weighing 1573 grams previously cut from the skull of a 27-year-old man. The coroner made every effort to ensure that the organ was in the hands of specialists in an almost perfect condition. “They took great care of everything,” admits the neuropathologist who led the study.
The lab itself was a 30-minute drive from the prison where the owner of the brain had hanged himself a night or two earlier. His name was known to scientists, as well as to other New Englanders and countless Americans from other parts of the country. The brain was transported approximately 30 miles north of where the deceased man last worked, the town of Foxborough, Massachusetts.
Someone his age was expected by specialists to have a rather ordinary brain. – I did not associate this man’s behavior with any disease – admits the neuropathologist. “I thought he was just what he was.”
On the autopsy table, the brain looked healthy. He was still wrapped in the meninges, layers of translucent membranes to protect this organ from injury. The brain also showed a healthy gloss.
First research
It began to be sliced, about an inch wide, beginning with the frontal portion. And immediately there were suspicions that this brain did not look like an organ at all from a 27-year-old. Even ordinary observation showed that the cross-sections showed significant defects in the brain tissue: fluid-filled chambers widening as the neurons die. The cross-section of a healthy 27-year-old’s brain is solid and full-bodied. This one, in turn, contained boomerang-shaped cavities. “If the skull grows, it is to make room for the expanding brain,” the neuropathologist explained to us. – It’s all packed inside there. Nature leaves no vacuum.
Meanwhile, in this case, the transparent septum, the tiny membrane between the two hemispheres of the brain, had shrunk to such an extent that it looked wilted, fragile, and perhaps even broken in places. If the neuropathologist were to point out other organs of the same condition as she had ever seen, the youngest and comparable would be from a 46-year-old boxer. The brain’s vault, a bundle of C-shaped neurons, clearly devoid of proper mass, was also extensively damaged. The hippocampus was still damaged. Even the most diseased brains examined by our interviewee, coming from the elderly, did not bear so many signs of destruction, noticed even when observed with the naked eye.
And yet only a microscope examination was able to diagnose the disease in its entirety. The wafer structure of the brain has been stained using antibodies to change the color of a specific protein – in this case tau, a tangling substance whose expansion leads to the death of neurons. Only this procedure revealed the actual extent of the damage.
Tau, played in brown, revealed itself like exploding fireworks in the part of the frontal cortex, the part of the brain responsible for making decisions, reacting to stimuli, and inhibiting behavior. The neuropathologist investigated how this protein spread also in other regions of the central nervous system. The lesions were in the amygdala, which regulates emotions such as fear or anxiety, and in the temporal lobe. The researcher found “perfect signs” of damage around tiny blood vessels, signs of pre-existing microbleeding, and gliosis, a scar-like growth of astrocytes around the brain’s ventricles.
More than damage
On a four-point scale describing the degree of brain damage [in chronic traumatic encephalopathy], the organ just described received a third degree. The researcher had never seen a brain so damaged before in a deceased person so young. Among the hundreds of other brains she examined, the organs of this magnitude of damage that would qualify for a grade three could belong to someone aged 67 or over, practicing the same profession as the deceased 27-year-old.
What makes this case so interesting from the scientific point of view, however, is not so much the extent of the damage to the young brain, but also its specific cause. Most of these badly damaged organs have belonged to people who have suffered numerous health problems over the course of their lives, from strokes to other neurodegenerative diseases like Alzheimer’s disease: so these samples are unclear and it is difficult to determine what damage was done by any single cause. Meanwhile, the brain we are talking about here seems to be a textbook example of the consequences of one specific disease. – It is rare for us to get a brain from such a young person in good shape – admits the neuropathologist. – This is a classic case that says a lot about this disease.
One such case?
The 27-year-old’s brain is basically no longer the brain, either functionally or in form, because it has been sliced - all of them numbered, archived and preserved. Scientists still brood over them – and it could go on for years, considering how fascinating this is.
The neuropathologist we interviewed and her closest associates kept the case a secret for months, until the deceased man’s family agreed to make the data public. So in September, the case made headlines, but the neuropathologist did not give interviews. She limited herself to making a brief statement with the results of her research. – I did not want to contribute to the atmosphere of sensation – he explains.
However, without presenting the research results, there will be no progress in science, so a few days ago the neuropathologist decided to speak to a body of more than 150 neurologists, pathologists and other researchers gathered in the university ballroom. She stood in a dark room, where she displayed a PowerPoint presentation of several dozen slides of an extremely degenerated young brain once owned by a former American football star, a man later convicted of murder. – He had a beautiful pathology, if the pathology can be said to be beautiful – previously admitted the researcher.
The individual damage to the athlete’s brain – tau protein tangles, damaged frontal cortex, weight loss, and enlarged ventricles – are well known to people with an interest in brain pathology. These are the dangers that people dealing with what the deceased 27-year-old must face. And it is under the microscope, in the dark laboratory and during scientific presentations in the scientific community that the fate of this discipline will be decided. “From the scientific point of view, it is all very interesting,” admits the neuropathologist. – I find it a fascinating brain.