Repeated head trauma within "window of vulnerability" before brain recovers from initial concussive injury
Can result in catastrophic brain swelling with permanent disability or death
2nd head injury in SIS typically minor, without immediate loss of consciousness
Severe vascular engorgement, brain edema, & herniation usually within minutes of 2nd injury
IMAGING
General Features
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Harmon KG et al: American Medical Society for Sports Medicine position statement on concussion in sport. Br J Sports Med. 53(4):213-25, 2019
Stovitz SD et al: What definition is used to describe second impact syndrome in sports? a systematic and critical review. Curr Sports Med Rep. 16(1):50-5, 2017
Cantu RC: Dysautoregulation/second-impact syndrome with recurrent athletic head injury. World Neurosurg. 95:601-2, 2016
Mckee AC et al: The neuropathology of traumatic brain injury. Handb Clin Neurol. 127:45-66, 2015
McKee AC et al: The neuropathology of sport. Acta Neuropathol. 127(1):29-51, 2014
Harmon KG et al: American Medical Society for Sports Medicine position statement: concussion in sport. Br J Sports Med. 47(1):15-26, 2013
Weinstein E et al: Second impact syndrome in football: new imaging and insights into a rare and devastating condition. J Neurosurg Pediatr. 11(3):331-4, 2013
Cantu RC et al: Second-impact syndrome and a small subdural hematoma: an uncommon catastrophic result of repetitive head injury with a characteristic imaging appearance. J Neurotrauma. 27(9):1557-64, 2010
Wetjen NM et al: Second impact syndrome: concussion and second injury brain complications. J Am Coll Surg. 211(4):553-7, 2010
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
2nd impact syndrome (SIS)
Synonyms
Dysautoregulation
Definitions
Repeated head trauma within "window of vulnerability" before brain recovers from initial concussive injury
Can result in catastrophic brain swelling with permanent disability or death
2nd head injury in SIS typically minor, without immediate loss of consciousness
Severe vascular engorgement, brain edema, & herniation usually within minutes of 2nd injury
IMAGING
General Features
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Harmon KG et al: American Medical Society for Sports Medicine position statement on concussion in sport. Br J Sports Med. 53(4):213-25, 2019
Stovitz SD et al: What definition is used to describe second impact syndrome in sports? a systematic and critical review. Curr Sports Med Rep. 16(1):50-5, 2017
Cantu RC: Dysautoregulation/second-impact syndrome with recurrent athletic head injury. World Neurosurg. 95:601-2, 2016
Mckee AC et al: The neuropathology of traumatic brain injury. Handb Clin Neurol. 127:45-66, 2015
McKee AC et al: The neuropathology of sport. Acta Neuropathol. 127(1):29-51, 2014
Harmon KG et al: American Medical Society for Sports Medicine position statement: concussion in sport. Br J Sports Med. 47(1):15-26, 2013
Weinstein E et al: Second impact syndrome in football: new imaging and insights into a rare and devastating condition. J Neurosurg Pediatr. 11(3):331-4, 2013
Cantu RC et al: Second-impact syndrome and a small subdural hematoma: an uncommon catastrophic result of repetitive head injury with a characteristic imaging appearance. J Neurotrauma. 27(9):1557-64, 2010
Wetjen NM et al: Second impact syndrome: concussion and second injury brain complications. J Am Coll Surg. 211(4):553-7, 2010
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