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

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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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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 › Clinical Neurology › Traumatic Brain Injury Research
Health Sciences › Medicine › Clinical 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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The Second Impact in Catastrophic Contact-Sports Head Trauma

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