Aaron Hernandez, a former New England Patriot’s player, committed suicide in April in his jail cell at the age of 27. Hernandez was serving a life-sentence for the murder of a friend. Recently conducted posthumous scans of the football player’s brain revealed that Hernandez had extensive damage due to chronic traumatic encephalopathy (CTE) caused by repeated head injury.

Researchers at Boston University found CTE in over 100 deceased football players, some of whom committed suicide. CTE can cause depression, dementia, aggression and confusion in people who have suffered traumatic brain injuries, such as football players. Symptoms can begin years or even decades after initial trauma, and CTE cannot be diagnosed until after death. In 2012, former Kansas City Chiefs linebacker Jovan Belcher killed his girlfriend, Kasandra Perkins, before killing himself. It was later found that Belcher’s brain had signs CTE.

Hernandez’s lawyers are pursuing a federal lawsuit against the NFL, claiming that the organization knew that CTE could result from repeated head collisions but did not attempt to protect Hernandez from head injury. Dr. Ann McKee, chief of neuropathology at the VA Boston Healthcare System and director of the CTE Center at Boston University, stated that slides of Hernandez’s brain showed classic signs of CTE, including “early brain atrophy” and brain perforations. A summary of McKee’s study of 111 brains of NFL players was published in the The Journal of the American Medical Association. Of these brains, 110 had CTE.

The recent research on the link between CTE and NFL players has encouraged the NFL to respond publicly. The organization has begun to advocate for children playing safer forms of football, such as flag football, instead of the traditional tackle football. Other researchers at Boston University recently found that adults who participated in tackle football before they were 12 years old developed more behavioral and cognitive problems than those who started later in childhood. In 2015, a federal judge approved a class-action lawsuit against the NFL filed by former players. The NFL was ordered to pay up to $5 million to each retired player with brain injuries resulting from his time in the NFL.

In 2010, rules within the NFL were changed to help limit the number of head injuries. These included whistling a play dead if a player loses his helmet and creating stricter return-to-play guidelines for players who have suffered concussions. New regulations for return-to-field play force a player with a potential concussion to be immediately escorted off the field, and the player will be examined by an NFL physician and an unaffiliated neurotrauma consultant (UNC). In previous years, NFL teams were known to keep players in the game regardless of concussions.

It is the will of the certified athletic trainers (ATC spotters) and UNCs to determine whether a player comes off the field after being hit.

Key players in crunch time rarely ever get removed for an evaluation, probably because the ATC spotter doesn’t want to be blamed for creating a competitive disadvantage,” Mike Florio of ProFootball Talk said.

The entertainment value of the NFL might not coincide with fan-favorite players being taken off of the field due to a potential concussion, argues Scott Davis of Business Insider.

The NFL has not made any public statements regarding Hernandez and his CTE diagnosis.

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