Colorado Springs Car Accidents: TBI Second Impact Syndrome

TBI Second Impact Syndrome

Written by Jeremy D. Earle, JD

February 6, 2023


Any traumatic brain injury (TBI) has the potential to be life-changing. Second impact syndrome, on the other hand, may cause far more severe symptoms in TBI sufferers (SIS).

When a TBI person experiences another concussion before the first one has fully recovered, second impact syndrome may ensue. A second hit might cause the previously injured brain tissue to inflate within the skull, causing catastrophic brain injury (known as cerebral edema).

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If the previous concussion has not healed, second impact syndrome may develop even from a bit of a hit on the head. For this reason, as well as others, all sufferers of concussions or other traumatic brain injuries should be placed on total physical rest until their injuries have healed fully.

When an athlete returns to sports too soon after a concussion, they develop second impact syndrome. The athlete does not need a second severe hit to the head to initiate the consequences. A simple blow to the head or a knock to the chest or back may be enough to break the athlete’s head and cause the brain to bounce within the skull.

“Irreversible brain injury may be caused with with a little amount of force. After a first brain injury, the brain is more fragile and prone to injury, and it only takes a little amount of force to induce irreparable damage.” Increased cerebral blood volume may lead to brainstem herniation and death if the brain’s capacity to self-regulate the amount of blood volume to the brain is impaired.

The pressure on the brain rises quickly, resulting in brain death in three to five minutes. Second impact syndrome has a significant mortality incidence in young athletes due to the rapidity of brain death.

In the literature, the true incidence of SIS is not reported (Bey, T. & Ostick, B., 2009). This might be because the symptoms of SIS are similar to those of catastrophic brain damage. If a thorough medical history isn’t collected, SIS may go unnoticed.

Second Impact Syndrome is a diagnosis

If a brain injury is suspected, a head computed tomography (CT) scan should be performed as a way. When it comes to detecting acute cerebral bleeding, a CT scan is more sensitive than an MRI. If the athlete is aware, a detailed medical history, including the cause of damage and previous head injuries, should be collected from the patient or an eyewitness if the athlete is made unconscious.

Second Impact Syndrome Symptoms

The athlete may not lose consciousness at first, but he or she may seem shocked. The athlete may be able to make it to the sidelines, where he or she will collapse within minutes.

The situation quickly worsens with the loss of awareness, lack of eye movement, dilated pupils, coma, and eventually respiratory failure. On the sidelines, all of this may happen in a matter of minutes.

Because this is a life-threatening situation, life-saving procedures must be implemented within minutes if the athlete is to have any chance of survival. Treatment should be given to preserving an airway and, if required, performing rescue breathing and CPR.

Who is afflicted with Second Impact Syndrome?

If an athlete returns to sports competition while still feeling symptoms from an earlier injury, he or she may be at risk for SIS. Every year, between 1.6 and 3.8 million sports-related concussions occur, according to research published in the Journal of Athletic Training (2007) and available on the Neurotrauma Research Laboratory website.

Second Impact Syndrome: How to Avoid It

Because young athletes have a greater death risk from SIS, prevention should be a priority. The key to avoiding SIS is ensuring that athletes do not return to sport after experiencing any post- concussion symptoms. To that aim, legislation is making its way through the country (at both the national and state levels) to require that athletes do not return to sport the same day they are concussed and that they do not return to an activity unless cleared by a sports medicine specialist.

Athletes, parents, coaches, athletic administrators, doctors, and sports medical workers must be educated about effective concussion diagnosis and care (particularly in light of current findings). As more people become aware of the hazards of SIS and the significance of good concussion care, the incidence of SIS should continue to decline.

Schools, colleges, and institutions that ignore the warnings and fail to treat concussions appropriately may pay the price alongside the wounded athlete.

In November of 2005, Stephen Anderson had a tragic second impact syndrome. He had had a concussion a month before, and it was discovered that he had not gotten sufficient care for his concussion. He proceeded to play football for La Salle University and was knocked unconscious during a football game when he collided head-on with an opponent player.

Anderson ‘s life was spared when doctors were able to remove a big blood clot from his head, but his brain was irreparably damaged, and he now struggles to walk and communicate.

The Pleverete family got a $7.5 million judgment from Colorado University after a jury determined that the school failed to properly treat Anderson ‘s initial concussion, resulting in second-impact syndrome.

The sports community should note that second impact syndrome may lead to severe and frequently deadly brain damage. The good news is that second impact syndrome can be avoided entirely.

Second Impact Syndrome Treatment

The goal of SIS therapy is to keep the patient stable, with a focus on airway care. The objective is to “normalise the raised intracranial pressure by reducing cerebral blood flow or fluid to the brain tissue” after the CT scan is done and establishes that there is an increased intracranial pressure. Hyperventilation, diuresis, fluid restriction, blood pressure management, steroids, or surgery may be used as therapies.


Although the pathogenesis of SIS is unknown, ideas propose that the significant cerebral swelling is caused by dysautoregulation of the blood arteries that feed the brain. It has been postulated that cerebral edema is managed by autoregulation, which controls blood flow to the brain during a first concussion.

A concussion is thought to affect cerebral metabolism, limiting the brain’s capacity to adapt effectively to successive concussions’ stress. As a result, a vulnerable period lasts around 10- 15 days following a head injury. Rapidly rising intracranial pressure may cause herniation and compression of the brainstem, resulting in pupil dilatation, respiratory failure, and death within minutes.

Recognize when you’ve had a concussion

If you’ve had any form of head trauma and are showing indications of a concussion, you should visit a doctor and be evaluated so you can prevent future concussions. It’s critical to get the right treatment for your concussion so that it heals as rapidly as possible. The symptoms of a first concussion vary from person to person. However, they usually involve the following:

  • Headaches
  • Nausea or vomiting
  • Confusion and disorientation
  • Fatigue and difficulties sleeping
  • Brief loss of consciousness
  • Slurred speech
  • Focus and concentration issues
  • Memory problems

Easy irritability and other personality changes

While some of these symptoms may be modest, second impact syndrome may grow much more severe. You may suffer the following symptoms if you get another hit or jolt to the head before your previous concussion has fully healed:

  • Loss of awareness
  • Loss of sight or movement of the eyes
  • Brain herniation
  • Severely dilated pupils
  • Inability to breathe (respiratory failure)
  • Death

Anyone who has been diagnosed with second impact syndrome needs immediate medical treatment, with an emphasis on keeping airways open and other forms of stabilization. Depending on the amount of the injury, neurosurgery may be necessary.

In sports, SIS

Athletes who participate in football, hockey, baseball, skiing, or boxing are more prone to second impact syndrome. This is because hitting your head is rather regular in certain activities, and as a result, a player may not be aware of the risk of concussion.

This is especially true if a coach or sports league does not place a high priority on safety and does not have regulations in place that demand medical assessments whenever a player collides with his or her head.

Furthermore, a coach or sports league should never pressurize a player to return to gameplay unless a medical specialist has approved them to do so. Returning to sports too soon after a brain injury may put a person at

danger of developing second impact syndrome and worsening the symptoms of their impairment. If someone behaves irresponsibly and produces second impact syndrome in an athlete or another person, that person should be held accountable.

For a free consultation, contact an experienced traumatic brain injury lawyer now

You should always consult an expert attorney with full knowledge of brain injuries and brain injury cases if you have suffered one traumatic brain injury, second impact syndrome, or catastrophic long- term problems as a result of many brain injuries. We at Warrior Car Accident Lawyers, understand how serious a brain injury can be, and we will fight to protect your rights to recovery. We provide free consultations and do not charge a fee until your case is won.

Please do not hesitate to contact our Colorado Springs, Colorado office at 719-300-1100 immediately.

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