The DOI matches its Crossref record; 6 of the 6 references it cites were found in a registry or an index.
The Second Impact in Catastrophic Contact-Sports Head Trauma
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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“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]
Citations
Cites
Nonsurgical management of extradural hematomas in children
Pang, D., Horton, J. A., Herron, J. M., Wilberger, J. E., & Vries, J. K. (1983) · Journal of neurosurgery · doi:10.3171/jns.1983.59.6.0958 · Cited by 157
The National Football Head and Neck Injury Registry. Report and conclusions 1978
Torg, J. S. (1979) · JAMA · doi:10.1001/jama.241.14.1477 · Cited by 132
An Evaluation of Decompression in Experimental Head Injury
Moody, R. A., Ruamsuke, S., & Mullan, S. F. (1968) · Journal of neurosurgery · doi:10.3171/jns.1968.29.6.0586 · Cited by 70
Head and Neck Injuries in Football: Mechanisms, Treatment, and Prevention
Schneider, M. D. R. C. (1973) · Medical Entomology and Zoology · Cited by 61
Management of severe cerebral edema in the metabolic encephalopathy of Reye-Johnson syndrome
Venes, J. L., Shaywitz, B. A., & Spencer, D. D. (1978) · Journal of neurosurgery · doi:10.3171/jns.1978.48.6.0903 · Cited by 37
Head Trauma in Football Players with Infectious Mononucleosis
Torg, J. S., Beer, C., Bruno, L. A., & Vegso, J. J. (1980) · The Physician and Sportsmedicine · doi:10.1080/00913847.1980.11948545 · Cited by 5
Cited by
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Unreported Concussion in High School Football Players: Implications for Prevention
McCrea, M., Hammeke, T., Olsen, G., Leo, P., & Guskiewicz, K. (2004) · Clinical Journal of Sport Medicine · doi:10.1097/00042752-200401000-00003 · Cited by 1,220
National Athletic Trainers' Association Position Statement: Management of Sport Concussion
Broglio, S. P., Cantu, R. C., Gioia, G. A., Guskiewicz, K. M., Kutcher, J. S., Palm, M., & McLeod, T. C. V. (2014) · Journal of Athletic Training · doi:10.4085/1062-6050-49.1.07 · Cited by 1,112
Epidemiology of Concussion in Collegiate and High School Football Players
Guskiewicz, K. M., Weaver, N. L., Padua, D. A., & Garrett, W. E. J. (2000) · The American Journal of Sports Medicine · doi:10.1177/03635465000280050401 · Cited by 851
The neuropathology of traumatic brain injury
McKee, A. C., & Daneshvar, D. H. (2015) · Handbook of clinical neurology · doi:10.1016/b978-0-444-52892-6.00004-0 · Cited by 899
Neurology (1997) · doi:10.1212/wnl.48.3.581 · Cited by 678
Metadata
- 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
- 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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