Secondary Impact Syndrome – Signs and Symptoms

Association of Educators
May 17, 2013 — 978 views  

Secondary impact syndrome (SIS) is a traumatic brain concussion injury that can occur to athletes that have already had at least one concussion in the past. When a second concussion occurs before all the symptoms have resolved from the first concussion, a traumatic brain injury actually alters the way the brain functions.

A concussion can also occur when someone's head or body is shaken violently, or if they receive a hard hit in the chest. This is one reason secondary impact syndrome is not always recognized quickly.

The brain needs time to properly heal from any head injury. Secondary impact syndrome may occur when an athlete returns to their sport before they have healed from the first injury. When they receive a second impact to the head, massive cerebral swelling can occur and cause death in just minutes. If they survive, they often have permanent brain damage.

A concussion alters the chemicals in the brain. This typically resolves in approximately one week; however, the time may vary from one individual to another. It is not resolved if the person is experiencing any of the symptoms.

The most common immediate signs and symptoms of a concussion are:

  • Headaches
  • Temporary loss of consciousness
  • Confusion
  • Slurred speech
  • Amnesia concerning the event
  • Dizziness
  • Ringing in the ears
  • Fatigue
  • Nausea and vomiting

Sometimes symptoms may not occur for hours or days after the injury. The symptoms to watch for in addition to the ones already listed are slightly different and may also indicate Secondary Impact Syndrome.

These symptoms include:

  • Problems with concentration or cognitive ability
  • Speech
  • Perception
  • Irritability, social/emotional interactions
  • Sensitivity to noise and light
  • Sleep disturbances
  • Taste and smell disorders
  • Psychological problems, including depression

Approximately 11 percent (300,000) of high school boys receive a second concussion annually. When an athlete has received a concussion, the chances of a second concussion are three to six times greater than an athlete that has never had an injury. It only takes a minor blow for the brain to rebound inside the skull and cause secondary impact syndrome.

When a second injury occurs, the individual may not lose consciousness, but just look stunned. They may be able to get up and walk to the sidelines. However, within minutes they may collapse and lose consciousness. Their pupils may be dilated and a coma ensues. They will very likely go into respiratory failure. This is an emergency that requires CPR and rescue breathing as the patient is rushed to the hospital.

The physician should be made aware of the previous concussion in order to provide the best treatment. There are very few clinical studies completed concerning SIS as it so often goes undiagnosed.

Prevention is the key to saving lives, which will ensure young athletes do not return to their sport if they have any symptoms from their first concussion. Education is necessary for coaches, parents, athletes, physicians and athlete administrators. There is legislation pending in Washington to require a medical release from a sports medical professional before an athlete may re-enter the game after suffering a concussion.

Association of Educators