Second Impact Syndrome

Second Impact Syndrome

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What is it?

Second impact syndrome is when an athlete or anyone gets an concussion and before he or she is fully healed from the previous concussion they return to sports and gets another head injury. When an athlete gets the second head injury before they are healed from the first head injury diffuse cerebral swelling, brain herniation and death can occur. Second Impact Syndrome can only occur after and two head injuries that happen right after one another in a short period of time. Since the brain is not fully healed from the first head injury it is very prone to being hurt and damaged again. It is possible getting another injury just by a simple hit to that head that may not seem that hard at the moment. The pressure to the brain can increase rapidly resulting in brain death. Many people who have a head injury think there symptoms go away before they actually do. It can take up to 6-18 months for your brain to be fully healed from an concussion. It is important to report your head injury as soon as possible and to not return to sports until you are approved by your doctor.

Table of Contents

  1. How it works

  2. Symptoms

  3. Treatment

  4. Affects on people around you

  5. College Students

  6. Cody Lehe
  7. Important to me

  8. Conclusion

  9. References

How it affects your brain

When an athlete suffers from an concussion they will experience several symptoms following the concussion. It can take the athlete minutes, hours, weeks, or months to get over these symptoms and to be able to play again. If the athlete returns to play before any of these symptoms are cleared and gets another hit to the head they have the possibility of getting second impact syndrome. Since the brain is already not fully healed the athlete doesn't even need a hit to the head to set it off. They can get hit in the chest or back that can jerk the athletes head and cause second impact syndrome. When they get hit the second time the brain is very vulnerable and not fully healed so the second initial hit can cause massive swelling to the brain very rapidly. Once the athlete gets hit they can seem fine and remain alert and still walk of the field or court. After 15 seconds to a minute after the hit they start to seem dazed and out of it. Once the swelling of the brain has started the athlete will collapse but still bet conscious. Their eyes will rapidly dilate and move back and forth and eventually they will loss consciousness and stop breathing. The brain is contained in the rigid bone of the skull. The swelling causing a lot of pressure on the brain, which in some cases can cause the brain to squeeze through little holes in the skull. When the brain squeezes through little holes within the brain this is called herniation. Herniation leads to decreased blood flow to the brain which eventually causes brain dead if it is not stopped in time.

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Symptoms of second impact syndrome are very similar to severe brain injuries which makes it hard to detect and can sometimes go undetected. All symptoms can happen seconds, hours, weeks or months after the second head injury. Many studies are still ongoing about second impact syndrome and how it can be detected earlier.

Some symptoms are:
  • Abnormal CT (computed tomography) of the brain
  • After hit looks stunned or stumbles around
  • Person loses consciousness or collapses shortly after the hitexternal image Signs_And_Symptoms_Of_Concussion.jpg
  • Loss of eye movement
  • Seizure
  • Dilated pupils
  • Person goes in to a coma
  • Respiratory failure


Many times the treatment for people with second impact syndrome doesn't doesn't turn out good. Second Impact Syndrome is very rare but can have a devastating effect on people who have it and their family. People who survive from the syndrome usually spend many weeks or months in a coma to let the brain swelling to go down. Many times doctors have to cut a hole the patients neck for a permeant breathing tube so they can breath by a machine because their brain is not functioning enough to do it for them. They get their nutrition, food and drinks from a tube because they are not alert enough to eat or drink. When treating a person who you think might have second impact syndrome the best thing to do is stabilize them. Make sure their airway is open and they are able to get air in to their lungs. CPR might be necessary in this instance. When the CT scan is complete and shows pressure on the brain, you have to restrict cerebral blood flow or fluid to brain tissue. Other treatments would include hyperventilation, fluid restriction to the brain, blood pressure control, steroids or surgery in worst cases. Many times second impact syndrome is very deadly if not caught in time and the brain just continues to bleed. A lot of times if an athlete has had several concussions they will be told by a doctor not to play sports anymore because they are so prone to getting second impact syndrome.

Second Impact Syndrome

Many times when an athlete gets hurt they won't tell anyone about it or will just try to ignore the fact that they are hurt. When a doctor or athletic trainer ask if they are doing okay and if their symptoms are all gone they refuse to tell them that they are still maybe feeling nauseous or getting frequent headaches from their first concussion. All they are worried about is getting back to the game and they don't realize that it can effect many other people in the long run if something really does happen to them like second impact syndrome. There have been many cases where athletes return to the game to soon and suddenly die because there brain has been swelling and they just never told anyone about their symptoms. Second Impact Syndrome doesn't just affect the athlete but also the family, athletic trainers and teammates.

Affects on medical personnel/ athletic trainers

  • Many are confused as to why the athlete wouldn't tell them about his or her symptoms.

  • Worry about how they could of taken other steps to prevent this.
  • Constantly worry about other teammates on the team refusing to tell them symptoms or downplaying their symptoms

  • Are very cautious on letting other athletes return to playing because they don't want it to happen again

  • Wonder if the coach had anything to do with downplaying the symptoms

Affects on Teammates

  • If they knew their teammate was still have symptoms they feel like it was their fault they got second impact syndrome

  • Feel like they should of told the athletic trainer, parents, or coach that they were still having symptomsexternal image THS-Footbal-Captains-2012.jpg

  • Heartbroken about the loss of their teammate

  • Only think about what they could have done to prevent the injury

  • They are scared they are going to get second impact syndrome

College Students and Second Impact Syndrome

Second Impact Syndrome relates to college students in many ways because athletes are very prone to concussions and head injuries with all the sports they are involved in. Football players are more likely to get second impact syndrome because they get hit so many times in just one game. Any football player who gets hit in the head and is having headaches usually will just ignore the symptoms and not tell anyone because they don't want to have to sit out and let the rest of their team down. One of the worst things you can do is not tell someone that your head is hurting and just ignore the symptoms. Ignoring the symptoms could be life threatening and you may not be able to play sports ever again if you don't do anything about it. Once you have one concussion its very easy to get another one because you head isn't healed from the previous concussion. After one and you keep on getting them its likely that you will have second impact syndrome because your brain is so damaged from the first one.

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Interesting video to watch!-

Cody Lehe

Cody Lehe is a high school football player that suffered from second impact syndrome. During a high school football game he got hit in the head really hard. He never got knocked out or loss consciousness but after the game just suffered from a really bad headache. His asked his mom to take him to the doctor the next day because the headache was unbearable. They did a CT scan on his brain and everything came back normal so he just continued to practice the next day thinking nothing of it. During practice he got hit again. The team took a water break and as he was standing in line to get a drink he passed out. This is when they realized he was suffering from second impact syndrome. Cody spent several months in the hospital. He is one of the lucky survivors of second impact syndrome. Although Cody survived still to this day he has many side affects from the syndrome and hasn't fully regained his walking abilities back yet. This was a wake up call for many high school football players who knew Cody to know how important it is to treat a head concussion right and not to play until you are fully healed. For more information on Cody's story visit the link below.

Cody's Story-

Important to me

The reason I chose second impact syndrome was because I have a close family member that has had several concussions and I wanted to learn about the affects of possibly having another one. My relative was told by a doctor that they are not allowed to play sports anymore because if they do and they would happen to get another concussion they have a huge possibility of getting second impact syndrome and having a serious brain injury or brain bleed. When the doctor told them they won't be able to play sports ever again it was very heartbreaking for them because sports is what they had done for their whole life and what they based their life around but its was worth not taking the risk of getting another head injury that could be life threatening. Learning about second impact syndrome has been very interesting to learn about because its something that interest me a lot and makes me aware of the outcomes of several concussions.


Second Impact syndrome is a very rare but fatal injury. It is always important to make sure you are fully cleared from your symptoms if you have had an previous concussion. It is better to play it safe then sorry when waiting to play because of an concussion because it could save your life. Many research is still going on about second impact syndrome in ways to prevent it and make sure everyone is fully healed from previous concussions before they are able to play again. It not only affect you but it effects everyone around you including you teammates, athletic trainers, coaches and family.


Barton, Lindsey. "Second Impact Syndrome: A Rare But Fatal Condition." Moms Team. Ed. William Meehan. Health and Safety Organization, n.d. Web. 3 Dec. 2013.

Beg, Tareg, and Brain Ostick. "Second Impact Syndrome." U.S National Library of Medicine. NCBI, n.d. Web. 3 Dec. 2013.

Cantu, Robert C. Clinics in Sports Medicine. Vol. 17. N.p.: Elsevier, 1998. 37-44. Web. 3 Dec. 2013.

Cifu, David. "Repetitive Head Injury Syndrome." Medscape. Medscape, 25 Apr. 2012. Web. 2 Dec. 2013.

Lupkin, Sydney. "High School Football Player Victim of Second Impact Syndrome." ABC News . N.p., 1 Jan. 2013. Web. 3 Dec. 2013.

"Second Impact Syndrome." Your Best Resource for Brain Injury . Newsome Melton LLP, n.d. Web. 2 Dec. 2013.

Standifer, Jason. "Look Who's Talking (To Me) When Don Hewitt Came Calling." Public Relations Tactics 6.1 (1999): 4.Business Source Elite. Web. 3 Dec. 2013.

Zeiger, Terry. "Second Impact Syndrome." Second Impact Syndrome. Sportsmd, n.d. Web. 2 Dec. 2013.