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Cited by 382Traumatic Brain Injury ResearchTraumatic Brain Injury and Neurovascular DisturbancesSports injuries and prevention

The Second Impact in Catastrophic Contact-Sports Head Trauma

Saunders, Richard L.·1984·JAMA: The Journal of the American Medical Association
DOI 10.1001/jama.1984.03350040068030
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Abstract

CATASTROPHIC brain injury following minor impact has been known to occur in contact sports, particularly football.1This peculiar susceptibility remains unexplained. However, the common resumption of contact play soon after concussion suggests that sequential minor impacts may occasionally lead to major cerebral pathological conditions. If these injuries have a compounding effect rather than representing isolated events, then additional impact to an already compliance-compromised brain might precipitate a catastrophic increase in intracranial pressure, perhaps through loss of vasomotor tone. We report a case documenting a preexisting cerebral contusion and the lethal effect of a second minor impact. This case suggests that clinical examination alone may sometimes be inadequate in evaluating persisting symptoms after minor head injury. In the athlete who has had a cerebral concussion, computed tomographic (CT) scanning may be required before medical clearance to resume play is justified. Report of a Case A 19-year-old, right-handed, college football player

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Crossref · 10.1001/jama.1984.03350040068030

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6 of 6 references verified0 citation errors · 0 not checkable

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  • Second-impact syndrome occurs when an athlete sustains an initial mild head injury or concussion, then suffers a second head injury before the symptoms associated with the first impact have cleared, with resultant diffuse cerebral swelling and grave deterioration.

    “Second-impact syndrome (SIS) occurs when an athlete sustains an initial mild head injury or concussion, then suffers a second head injury before the symptoms associated with the first impact have cleared, with resultant diffuse cerebral swelling and grave deterioration [19, 20, 113, 133, 137, 164].”

    From The neuropathology of sport (2014) · cites this paper as [164]

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Authors
Saunders, R. L.
Affiliations
Dartmouth College (US)
Corresponding author
Saunders, Richard L.
Venue
JAMA: The Journal of the American Medical Association
Publisher
American Medical Association (AMA)
Published
1984-07-27
Volume
252
Issue
4
Pages
538
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.1984.03350040068030
OpenAlex
W2005040118
Cited by
382
References
6
Citations by year
2026: 2 · 2025: 2 · 2024: 4 · 2023: 7 · 2022: 5 · 2021: 10 · 2020: 26 · 2019: 16 · 2018: 4 · 2017: 8 · 2016: 18 · 2015: 18 · 2014: 24 · 2013: 13 · 2012: 16
FWCI
1.96
Type
journal article
Language
en
Open access
closed
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
Keywords
second impact syndrome, contact sports, football, concussion, cerebral contusion, intracranial pressure, vascular tone, computed tomography, return to sport, medical clearance
MeSH terms
Adult, Athletic Injuries, Brain Concussion, Football, Hematoma, Subdural, Humans, Male, Radiography

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