Washington State quarterback Tyler Hilinski had signs of chronic traumatic encephalopathy (CTE) when he took his own life in January. While this revelation doesn't provide many answers, it does prompt copious questions.

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If you’re expecting solutions here, let me spare you the time. Those aren’t going to come within 24 hours of the latest Tyler Hilinski news.

Surprising as it was to learn that the former Washington State quarterback had signs of chronic traumatic encephalopathy (CTE) when he took his own life in January, this revelation doesn’t provide many answers. It does prompt copious questions, though.

If you’re unfamiliar, CTE is a degenerative brain disease found in athletes (and others) with a history of excessive hits to the head. It has been associated with memory loss, depression, dementia, aggression, impaired judgment and other conditions.

Though it can only be diagnosed postmortem, CTE has been discovered in the brains of hundreds of former NFL players. But for it to happen to a 21-year-old quarterback who only played 12 collegiate games, mostly as a backup?

Warning signs of suicide

If you are experiencing suicidal thoughts or have concerns about someone else who may be, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). You will be routed to a local crisis center where professionals can talk you through a risk assessment and provide resources in your community. The more of the signs below that a person shows, the greater the risk of suicide.
  • Talking about wanting to die
  • Looking for a way to kill oneself
  • Talking about feeling hopeless or having no purpose
  • Talking about feeling trapped or in unbearable pain
  • Talking about being a burden to others
  • Increasing the use of alcohol or drugs
  • Acting anxious, agitated or recklessly
  • Sleeping too little or too much
  • Withdrawing or feeling isolated
  • Showing rage or talking about seeking revenge
  • Displaying extreme mood swings
Source: National Suicide Prevention Lifeline

How?

That’s what Dr. Julian Bailes, a neurosurgeon at NorthShore University HealthSystem in Chicago, wondered when he initially heard about Hilinski’s autopsy. Most examples of CTE are found in players who incessantly endured “sub-concussive” hits in practice and games throughout their relatively long careers. They aren’t found in second-stringers whose teammates weren’t allowed to touch them in practice.

Sure, Hilinski did tell his older brother about a hit that “rocked” him during WSU’s game against Arizona last season. And Tyler’s parents said that they started to notice changes in Hilinski’s behavior after that game.

But to make a boxing analogy, it isn’t typically the knockout blows researchers associate with CTE — it’s the 12 rounds of jabs that occur fight after fight.

That’s why Bailes wondered what else might have gone into Hilinski’s situation. Were there hits in high school that may have contributed? Factors outside of football? And perhaps biggest of all: How much of this was hereditary?

“This makes you wonder about the genetic aspects to CTE. Like everything in our health, whether it’s cancer or heart disease, these are genes we get from our parents,” Bailes said. “There’s not been a known gene that predisposes you to CTE. This is a very interesting case.”

Here’s another question: Could youth football have played a role? Remember, it was just a couple days ago that Hall of Fame quarterback Brett Favre said that Pop Warner should be outlawed. Hilinski played nothing but quarterback from high school on, but his parents did say he played linebacker in junior high.

Only problem is that it was only for a short time. And according to Bailes, youth players’ size and relative lack of velocity remove most of the head-injury risk.

But is it possible that, despite Hilinski’s lack of exposure in college, CTE is just a whole lot easier to come by than most people think?

That’s what Chris Dore, a partner at Edelson PC contends. Dore’s law firm is involved in scores of class-action lawsuits filed against the NCAA by former football players who feel they are suffering from CTE. Memory-loss, depression, impaired judgment — Dore says all the symptoms are there.

“I’m not surprised in the slightest,” said Dore when asked about Hilinski having CTE. “It’s a tragic, terrible thing that happened, but unfortunately that can be expected from the disease.”

Again, though, there’s a problem: CTE can only be diagnosed postmortem. These former players might be suffering from the disease, but it’s impossible to say for sure (also, Dore had a bizarre theory that “behind closed doors,” Hilinski was getting hit in practice, so take his words how you will.)

And this leads to what is easily the most uncomfortable question yet: Should we be careful not to overreact to Hilinski’s diagnosis?

Tuesday, I came across an interesting piece from Yahoo! sports writer Eric Adelson, who wrote about some of the misconceptions surrounding CTE. Though doctors and scientists are glad that the risks of CTE via contact sports are coming to light, there was a thought that appropriate concern had morphed into counterproductive fear.

He told a story of an amateur athlete who, upon suffering from depression and memory-loss, was so convinced he had CTE that he took his own life. He actually had vasculitis, which was treatable.

In a column for the Huffington Post, Brooke de Lynch — director of the MomsTeam Institute and head-trauma educator — delved into similar territory. As part of an argument that the media’s CTE narrative is “literally scaring people to death,” she noted how former NHL player Todd Ewen also took his own life because he thought he had CTE, only for his postmortem autopsy to reveal he didn’t.

What happened to Tyler Hilinski was tragic, just as it was for Junior Seau and Dave Duerson — two former NFL players revealed to have had CTE after killing themselves. His age and position raised terrifying concerns about who this disease can afflict.

We don’t have answers or solutions yet. But we can’t stop asking questions until we do.