Review Question - QID 217375

Second impact syndrome relates to catastrophic cerebral edema due to a second head trauma before symptoms of the initial concussion have resolved and is associated with a mortality rate of almost 50%.

Concussions are a subset of mild traumatic brain injury (mTBI) characterized by acute transient impairment of neurologic function secondary to an impulsive force transmitted to the head. Treatment focuses on removal from play with a graduated return to play regimen. Second impact syndrome is a feared complication that may occur following a repeat impact prior to the resolution of concussion symptoms. This results in cerebral edema and is associated with a mortality rate approaching 50%. Second impact syndrome is associated with male gender, young age and American football.

Putukian et al review the clinical evaluation of a concussed patient. They report that the sideline concussion evaluation should consist of a symptom assessment and a neurologic examination that addresses cognition (briefly), cranial nerve function, and balance. They conclude that clinicians should err on the side of caution when determining return to play.

Stovitz et al review second impact syndrome. They report second impact syndrome is as a syndrome resulting in catastrophic brain injury (e.g., cerebral edema) in a person who suffers a head trauma while still recovering from the effects of a recent concussion. They conclude that the mortality rate of second impact syndrome is high, with most articles citing somewhere between 50-100%.

Incorrect Answers:
Answer 2: Chronic traumatic encephalopathy results from repetitive brain trauma, not second impact syndrome specifically.
Answer 3&4: Second impact syndrome results in cerebral edema, not bleeding from any specific system.
Answer 5: No direct link has been made between short term memory loss and second impact syndrome.