Background Chronic Traumatic Encephalopathy (CTE) is a progressive neurodegenerative disease associated with repetitive head trauma, predominantly affecting contact sports athletes and military personnel. Given the high prevalence of traumatic brain injuries (TBI) managed by neurosurgeons, it is crucial to understand CTE's pathophysiology, clinical presentation, and management strategies to enhance patient outcomes. Methods A systematic review and meta-analysis were conducted following PRISMA guidelines. Searches were performed in PubMed, Cochrane Library, Embase, and Google Scholar for studies published from January 2010 to May 2024. Inclusion criteria encompassed studies on CTE epidemiology, pathophysiology, clinical presentation, diagnostics, and therapeutics. Data extraction and quality assessment were conducted independently by two reviewers, with discrepancies resolved by a third reviewer.

Results Fourteen studies met the inclusion criteria, totaling 2729 observations and 799 events of CTE. The pooled proportion of CTE cases was 72.82% (95% CI: 48.17% to 88.53%) using a random effects model, with substantial heterogeneity (I2 = 98.6%). Subgroup analysis indicated high pooled proportions among athletes (71.43%) and military personnel (74.29%). Sensitivity analysis confirmed the robustness of the findings. The pathophysiology of CTE involves the accumulation of hyperphosphorylated tau protein and chronic neuroinflammation, leading to significant neuronal damage. Clinically, CTE presents with cognitive impairment, mood disorders, and behavioral changes, complicating its diagnosis due to overlapping symptoms with other neurodegenerative diseases. Current treatments focus on symptomatic management, with emerging therapies targeting tau pathology and neuroinflammation showing promise.

Conclusion This meta-analysis underscores the significant prevalence of CTE among individuals exposed to repetitive head trauma, highlighting the need for standardized diagnostic criteria and personalized management approaches. Neurosurgeons are pivotal in advancing diagnostic protocols and therapeutic strategies to improve outcomes for patients with CTE. Further research is needed to enhance understanding and management of CTE, ultimately benefiting the broader TBI patient population frequently encountered in neurosurgical