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The tragic death of Manly junior Keith Titmuss four years ago has been the subject of multiple investigations but there was one thing we didn't know until now.
Research has shown the toll the 20-year-old's sporting career took on his brain, with his his parents labelling the findings a "wake up call" for young athletes.
From a footy loving five-year-old to a rising junior playing rugby league for Newington, before hitting the big leagues.
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Tittmus loved the game but it came at a cost.
A coronial inquest found the 20-year-old died from heat stroke during a Manly Sea Eagles training session in 2020.
Following his tragic death, his family donated his brain to the Sporting Brain Bank where neuropathologist, Michael Buckland, made an unexpected discovery.
"Keith's brain had unequivocal sign of Chronic traumatic encephalopathy, or CTE," Buckland told 9News.
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Tissue samples of Titmuss's brain showed brown CTE lesions, all despite never knowingly being concussed or knocked out.
"I was surprised that in a 20 year old you can have a significant burden of this disease that someone hadn't really exhibited and signs or symptoms," Buckland said.
Titmuss' mum and dad say this research is a "wake up call" to other parents. It proves CTE can occur in young people who play contact sport even if the symptoms don't show at the time.
The findings only strengthening calls to make contact-sport safer for all age groups.
"Keith grew up playing under modern concussion protocols," Buckland said.
"He had the best of care at home, the best of care at school and none of that was enough to protect him from that disease."
