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Related Experiment Videos

Does second impact syndrome exist?

P McCrory1

  • 1Centre for Sports Medicine Research & Education, and Brain Research Institute, University of Melbourne, Australia. pmccrory@compuserve.com

Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine
|August 10, 2001
PubMed
Summary

Second impact syndrome (SIS) is likely diffuse cerebral swelling, a known traumatic brain injury complication. We propose renaming SIS to diffuse cerebral swelling for clarity in clinical practice.

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Area of Science:

  • Neuroscience
  • Sports Medicine
  • Pediatric Traumatology

Background:

  • Second impact syndrome (SIS) is a feared but controversial complication of traumatic brain injury (TBI).
  • The premise of SIS occurring after recurrent concussions lacks compelling evidence.
  • Existing literature on SIS is debated, necessitating a review of supporting and refuting evidence.

Purpose of the Study:

  • To critically review the evidence for and against the existence of second impact syndrome.
  • To propose an alternative explanation for the clinical presentation attributed to SIS.
  • To advocate for the abandonment of the term SIS in favor of a more accurate clinical descriptor.

Main Methods:

  • Systematic review of published literature on second impact syndrome and related TBI complications.

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  • Analysis of clinical case reports and epidemiological data associated with SIS.
  • Comparative analysis of the clinical characteristics of SIS and diffuse cerebral swelling.

    • Main Results:

    • The evidence supporting SIS as a distinct entity following recurrent concussions is not compelling.
    • The clinical presentation and demographics of SIS align closely with diffuse cerebral swelling, a recognized TBI complication.
    • Diffuse cerebral swelling is more prevalent in pediatric and adolescent populations, mirroring SIS demographics.

    Conclusions:

    • Second impact syndrome is likely not a distinct pathological entity but rather a manifestation of diffuse cerebral swelling.
    • The term "second impact syndrome" is misleading and should be abandoned.
    • Clinicians should adopt the term "diffuse cerebral swelling" to accurately describe this condition in patients with traumatic brain injury.