By Ken Belson

New York Times News Service

WILDWOOD, Mo. — The news at first seemed to shock the medical world studying the relationship between hard hits to the head in sports and a degenerative neurological disease called CTE.

Todd Ewen, one of hockey’s most aggressive fighters, who fatally shot himself at age 49 in September 2015, did not have the disease, despite displaying a wide range of symptoms for it.

That was the conclusion of doctors in Toronto. It turned out to be wrong.

Ewen’s wife, Kelli, was skeptical about the Toronto doctors’ conclusion and had her husband’s brain tissue tested by doctors at Boston University’s CTE Center, whose findings were checked by researchers at the Mayo Clinic.

Ewen, they said Friday, did in fact have CTE, stoking the debate about the disease’s relationship to hockey instead of tempering it.

Kelli Ewen was dismayed but not surprised at the new finding.

In the years before he committed suicide, Todd Ewen, who had retired after the 1996-97 season, showed many of the symptoms linked to the disease, she said, including depression, memory loss, mood swings and sleeplessness.

“It was like checking boxes on a list,” said Kelli Ewen, who was married to Todd for 28 years. “Check, check, check. Every symptom of CTE, Todd had.”

Todd Ewen joins a growing list of former NHL “enforcers” found to have had the disease, including Derek Boogaard, Bob Probert and Steve Montador. The primary job of an enforcer is to fight an opponent on the ice as a way to avenge a perceived wrong.

The new findings are likely to raise questions about how, in 2016, the doctors in Toronto missed the brain lesions that are the telltale signs of a disease that can be diagnosed only posthumously. The neuropathologist who oversaw the first test, Lili-Naz Hazrati, was an expert witness for the National Hockey League in CTE-related litigation, a potential conflict of interest.

The new diagnosis, which was first reported by TSN, a Canadian broadcaster, will also shine a light on the NHL, whose commissioner, Gary Bettman, pointed to Ewen’s first test to cast doubt on the links between CTE and the sport of hockey and to fend off lawsuits from former players who said the NHL had misled them about the dangers of the sport.

Most of all, the diagnosis provides some closure for Kelli Ewen, who watched her husband’s life spiral out of control and who was mortified when the initial conclusion that he did not have CTE, or chronic traumatic encephalopathy, became a prop in the wider war over the disease between sports leagues and scientists.

“Now I have a reason for how and why all this happened,” Kelli Ewen said in her home outside St. Louis. “How could one expert find no CTE at all? So we asked another expert, who said there is no way a 49-year-old man with repeated head trauma didn’t have signs of CTE.”

Kelli Ewen said she knew nothing about CTE until Todd mentioned it a year before he died. By that point, he was forgetting even simple tasks and conversations, withdrawing socially and lashing out with little prompting. She had no inkling he had a corrosive brain disease. The couple sought therapy for a few years.

Todd Ewen, though, sensed something more serious was wrong and began reading about CTE and its links to other athletes who suffered repeated head trauma, including hockey enforcers.

During his career, Ewen, who played for the St. Louis Blues, Montreal Canadiens, Anaheim Mighty Ducks and San Jose Sharks, broke three knuckles and every finger on both hands. His nose was reconstructed three times and one of his eye sockets was shattered. He blew out both knees. He had multiple concussions, black eyes and stitches on his face. Once, a player punched him so hard the screws on the inside of Ewen’s helmet were driven into his forehead.

“If a fighter got a concussion, it was just part of the game,” Kelli Ewen said of hockey enforcers in the 1980s and 1990s, when her husband played. “But I can tell you there were many nights he came home and couldn’t see, or was blurry out of one eye for days, or had headaches, or was confused for 24 hours after a serious fight.”

Ewen’s statistics reflected his role as a pugilist. He had only 36 goals but 1,911 penalty minutes in 518 regular-season games.

After he retired, Ewen became an investment broker, worked in real estate, received five patents for various inventions and earned a degree in information technology. He coached the St. Louis University hockey team for several years, but he resigned in 2013 because he started to miss practices and forget plays.

Afterward, he became more reclusive, his widow said. He started carrying a yellow notepad so he could remember what errands to run. Doctors prescribed antidepressants, but they made his moods worse, she said.

“In the morning, I’d wake up and wonder if I was getting the mad Todd or the sad Todd,” she said. “Todd knew there was something wrong with Todd. He kept saying, ‘There’s something wrong with my brain, I don’t know what it is, but there’s something wrong.'”.

With the new diagnosis in hand, Kelli Ewen is trying to move on from what has been an emotional roller coaster.

“Looking back, it makes me sad because if I had known why he was sick, it would have changed things a lot,” she said. “Something good has to come out of Todd’s passing. I don’t want other families to have to go through what I had to go through.”