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Second impact syndrome: A devastating injury to the young brain
Date:1/1/2013

njury. Findings in this case do not substantiate that claim because the CT scan was normal. Weinstein and colleagues point out that several types of injury do not necessarily register on an imaging study, and " a normal head CT scan does not obviate the need for close clinical follow-up and for the athlete to be cognitively normal and asymptomatic before return to play."

In this case, the patient experienced severe headaches throughout the interval between injuries. The authors state that evidence of persistent, long-lasting, severe headaches, which have repeatedly been identified in patients with SIS, indicate an ongoing and significant pathological neurophysiological condition in the absence of evidence on the CT scan. The authors suggest that this symptom may be a specific predictor for the possibility of SIS if a second injury occurs before the first has resolved.

The take-away message in this study, according to coauthor Dr. Michael Turner, "is that there must not be a return to play if the athlete is at all symptomatic. A normal CT scan will not identify a patient who can be released to play. The mechanism of SIS is probably hyperemia [increased blood in the brain], not occult hematoma."

SIS rarely occurs, but when it does the effect is usually devastating. Often the patient dies. The authors stress the importance of educating coaches, athletes, family members, and treating physicians about the risks and possible consequences of sports-related head injuries.


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Contact: Jo Ann M Eliason
jaeliason@thejns.org
434-982-1209
Journal of Neurosurgery Publishing Group
Source:Eurekalert

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