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Understanding Second Impact Syndrome

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Perhaps thanks to professional sports leagues, concussions have become a hot-button issue within the medical community. Rules changes in the National Football League were enacted to protect players not only from concussions, but from further injury after suffering a concussion. Beginning with the 2010 season, NFLplayers who were diagnosed with a concussion during a game were not allowed to re-enter the game and were subject to thorough testing in the days following to determine if they would be allowed to play the following week. If they failed the tests, they were not cleared to play.
Though protecting its players was at the core of that rule change in the NFL, a condition known as second impact syndrome might have also played a role in the league’s decision. A rare condition in which a second concussion occurs before a first concussion has healed, second impact syndrome causes severe and rapid brain swelling. Fans of the NFL, and other sports where the risk of head injury looms large, as well as parents of athletes and athletes themselves can educate themselves about second impact syndrome to get a better idea of just how important it is to emphasize safety when it comes to head injuries.
Who is most at risk?
Due to the nature of certain sports, athletes, and particularly young athletes, are most at risk for second impact syndrome. According to BrainandSpinalCord.org, an online resource for brain injury and spinal cord injury survivors, second impact syndrome is most common among young people who play football, hockey and baseball as well as those who ski or box. These sports can be especially violent, even for youngsters.
How soon can second impact syndrome occur?
A second impact injury can occur within minutes of a first concussion. Such a reality only highlights the importance of the NFL’s decision to keep players from returning to games in which they have suffered a concussion. Athletes young and old should never return to a competition if they have suffered a concussion. In order to avoid further damage, players must be removed from the competition and stay on the sidelines until fully healed. A second impact injury might also occur days or even weeks after the first concussion, and the impact does not have to be severe for a second impact injury to occur.
What are the symptoms of second impact syndrome?
Symptoms of a second impact injury typically occur immediately after the injury. Some of the more common symptoms include:
* Dilated pupils
* Loss of eye movement
* Appearance of being stunned
* Unconsciousness
* Sudden collapse
*  Respiratory failure
After an initial brain injury, the brain is so vulnerable that even minimal impact can cause irreversible damage. When the injury occurs, the brain struggles to control the amount of blood volume to the brain and, as a result, a second impact injury can lead to rapid brain death, which occurs in as few as three to five minutes in certain instances. Such rapid brain death is one reason for the high fatality rate among young athletes who have suffered a second impact injury. Long-term effects of second impact syndrome are similar to those of severe traumatic brain injury. Speech, cognitive ability, sensory ability, perception, and social and emotional interactions might be permanently affected after a second impact injury.
Athletes who complain of or demonstrate any of the symptoms of second impact syndrome should be pulled from their competition immediately and visit a sports medicine physician for follow-up care. The worst thing to do is minimize the significance of a concussion or its symptoms, especially if it’s a second impact injury