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What is Second

Impact Syndrome?



This springs up when an athlete, who has already sustained a head injury, sustains a second head injury before symptoms have cleared from the first injury. Many periods this springs up because the athlete has returned to competition and play before his or her first injury symptoms resolve. Coaches and athletes do not realize that days or weeks may be required before concussion symptoms resolve.



A second blow to the head, even if it's a minor one, can result in a loss of auto regulation of the brain's blood supply. Loss of autoregulation leads to brain swelling. This outcomes in increased intracranial pressure and leads to herniation of the brain. The general time from second impact to brainstem failure is quite rapid, taking two to five minutes. Once herniation and brainstem compromise occur, ocular movement and respiratory failure are likely to result.



How can Second

Impact Syndrome

be detected?





Even though fatal effects of Second Impact Syndrome can eventuate rapidly, some measures can be taken to investigate the undermine or catastrophic effects. Magnetic Resonance Imaging (MRI) is more sensitive to traumatic brain injuries (e.g., oedema) compared to Computed Tomography (CT Scan) which is used for showing bleeding or midline shifts in the brain requiring neurosurgery.

The the bulk obvious prevention of second impact syndrome is to recognize symptoms of concussion and do not return athletes to competition prematurely or before symptoms have resolved.



Athlete Reaction to

Second Impact Syndrome



Within seconds or minutes of the second impact, the athlete who is conscious, yet stunned may:

-collapse to the ground

-semicomatose with rapidly dilating pupils

-loss of eye movement

-evidence of respiratory failure



Incidence



Second impact syndrome the bulk likely affects young athletes (junior and senior high school), however, any athlete who returns to play too soon is a possible candidate. Incidence of second impact syndrome is difficult to calculate because the population at risk is unknown. However, between 1992-1997, 17 cases of second impact syndrome were reported due to football injuries alone. Football, as well as a lot other sports (e.g., hockey, boxing, skiing, etc.) can cause successive injuries leading to this syndrome. Following are examples of when an injury can be proven to be fatal.