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Cited by 91Traumatic Brain Injury ResearchTraumatic Brain Injury and Neurovascular DisturbancesSports injuries and prevention

Acute hemispheric swelling associated with thin subdural hematomas: pathophysiology of repetitive head injury in sports

Mori, T., Katayama, Y., Kawamata, T.·2006·Acta Neurochirurgica Supplementum
DOI 10.1007/3-211-30714-1_10
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Abstract

Introduction The most common head injury in sports is concussion, and repeated concussions occurring within a short period occasionally can be fatal. Acute subdural hematoma is the most common severe head injury and can be associated with severe neurologic disability and death in sports. We investigated severe brain damage resulting from repetitive head injury in sports, and evaluated the pathophysiology of sports-related repetitive injury.Methods We reviewed the literature containing detailed descriptions of repetitive severe sports-related head injury. In total, 18 cases were analyzed with regard to age, gender, type of sports, symptoms before second injury, and pathology of brain CT scans.Results The majority of cases involved young males aged 16 to 23 years old, who sustained a second head injury before symptoms from the first head injury had resolved. Ten of 15 cases did not suffer loss of consciousness at insult. Eight cases were confirmed on brain CT scans after the second injury, and all 8 cases revealed brain swelling associated with a thin subdural hematoma.Conclusions Second impact syndrome is thought to occur because of loss of autoregulation of cerebral blood flow, leading to vascular engorgement, increased intracranial pressure, and eventual herniation. Our investigation suggests that the existence of subdural hematoma is a major cause of brain swelling following sports-related, repetitive head injury.

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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 [137]

  • All reported cases of second-impact syndrome have involved young athletes, predominantly males (90%) ranging in age from 10 to 24 years, mean age 17.9 years.

    “All reported cases of SIS have involved young athletes, predominantly males (90 %) ranging in age from 10 to 24 years, mean age 17.9 years [137].”

    From The neuropathology of sport (2014) · cites this paper as [137]

  • In two-thirds of second-impact syndrome cases, a thin, acute subdural hematoma has been reported on neuroimaging or at autopsy.

    “In two-thirds of cases, a thin, acute subdural hematoma has been reported on neuroimaging or at autopsy [19, 137]”

    From The neuropathology of sport (2014) · cites this paper as [137]

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Authors
Mori, T., Katayama, Y., & Kawamata, T.
Affiliations
Nihon University (JP)
Corresponding author
Mori, T.
Venue
Acta Neurochirurgica Supplementum
Publisher
Springer-Verlag
Published
2006-06-21
Volume
96
Pages
40-43
DOI
10.1007/3-211-30714-1_10
OpenAlex
W206679251
Cited by
91
References
18
Citations by year
2026: 1 · 2025: 1 · 2024: 2 · 2023: 3 · 2021: 4 · 2020: 3 · 2019: 4 · 2018: 4 · 2017: 6 · 2016: 12 · 2015: 8 · 2014: 6 · 2013: 3 · 2012: 7
FWCI
16.28
Type
book chapter
Language
en
Open access
closed
Locations
  • Springer eBooks (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, repetitive head injury, sports-related head injury, subdural hematoma, cerebral edema, cerebral autoregulation, intracranial pressure, brain herniation, concussion, youth athletes
MeSH terms
Adolescent, Adult, Athletic Injuries, Brain Edema, Craniocerebral Trauma, Humans, Male, Prognosis, Recurrence, Syndrome, Hematoma, Subdural, Acute

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