Autopsy: Ex-NFL player who shot 6 shots sustained severe brain trauma.

Dr. Ann McKee examined Phillip Adams' brain and determined that he had stage 2 chronic trauma encephalopathy.

According to authorities, Phillip Adams shot and killed Robert Lesslie, a Rock Hill doctor; his wife Barbara; their two grandchildren Adah Lesslie (9 years old) and Noah Lesslie (5 years old); and Robert Shook (38), two HVAC technicians who worked at the Lesslie home. Later, police found Adams with a self inflicted gunshot wound on the head.

CTE, a degenerative disease that is associated with head trauma and concussions, has been shown to cause a variety of symptoms including mood swings and memory impairment.

McKee stated that there were indications that he was having cognitive and behavioral issues. He didn't seem to snap. It seemed to be a progressive cumulative impairment. He was becoming more paranoid and was experiencing increasing memory problems. It was also possible that he was engaging in more impulsive behavior. ... Although it may not have been known, I doubt that this was an isolated incident." McCkee, who directs Boston University's CTE Center, stated that 24 NFL players were diagnosed with the disease in their 20s and 30s. Most had stage 2 like Adams. There are four stages to the disease, with stage 4 being most severe and often associated with dementia.

McKee stated that the second stage is associated to progressive cognitive and behavioral abnormalities like aggression, impulsivity and explosivity as well as paranoia and anxiety.

Adams' CTE diagnosis was unique among the others, as it was "unusually severe in both of her frontal lobes," she explained.

McKee likened Adams' brain to Aaron Hernandez, a former football star who was posthumously diagnosed as having CTE. Hernandez died in prison at 27 after being sentenced to a life sentence for a 2013 crime.

The Lesslie family expressed appreciation for the diagnosis.

Their family stated that they found some comfort in CTE results and the explanations they provided for their irrational behavior in this tragedy, even though it was heartbreaking.

Adams' family stated that they weren't surprised by his diagnosis, but were shocked at the severity of his condition.

Their statement stated that they had reviewed his medical records and discovered that he was desperate for help from the NFL. However, he was denied all claims because he couldn't remember simple tasks like driving long distances to see doctors or going through extensive evaluations.

Adams' agent previously stated to The Associated Press, that Adams had not participated in the variety of mental and physical health programs available for ex-players via the NFL and its union.

Adams' agent and the football league did not respond immediately to our requests for comment.

CTE can only be diagnosed by an autopsy. It has been detected in ex-military personnel, football players, boxers, and other people who have suffered repeated head trauma. A recent study revealed signs of the disease in 110 out of 111 NFL players who had their brains examined.

Adams, 32, was a player in 78 NFL games, for six different teams, over six seasons. As a seventh-round pick from South Carolina State, Adams joined the San Francisco 49ers as a draft pick in 2010. He played in 78 NFL games for six teams over six seasons. After retiring, Adams continued his career with Atlanta Falcons in 2015.

Adams was a rookie and suffered a serious ankle injury. He never played again for the 49ers. Later with the Raiders, Adams suffered two concussions in three games in 2012. He didn't retire before 2014 so he would not have been eligible to be tested as part of a large settlement between the league, former players and long-lasting concussion injuries.

According to Sabrina Gast, York County Coroner Sabrina Gast, Adams' family said that Adams suffered from excruciating pain due to his injuries. They also claimed that Adams had memory problems and trouble sleeping.

After the murders, Adams' sister spoke out to USA Today that Adams' mental health had "degraded fast and horribly" over the past few years. She also stated that the family was seeing "extremely concerning" signs and symptoms of mental illness such as an increase in temper and neglecting personal hygiene.

Gast stated that pathologists also discovered amphetamines in Adams' system, for which Adams had a prescribed, and unregulated drugs kratom at Adams' time of death.

According to affidavits, investigators found several guns, ammunition and "numerous notebooks...with cryptic writing and different designs and emblems" among Adams’ belongings.

Kevin Tolson, York County Sheriff, stated that police would likely close their investigation after reviewing the writing. However, he stressed that Adams' CTE diagnosis along with the other findings may not be conclusive in explaining Adams' actions of violence.

Toland stated, "Sometimes we get the why, other times we don't." "There is only one person who knows the why, and that's dead. "We may never know, in this life or on this planet, what the why is."