If your brain doesn't get to recover properly from one concussion before sustaining another concussion -- even a seemingly mild one -- the damage can be far worse, long-lasting, even fatal. Produced by Vicky Youcha and Brian King.
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With children and mild concussion, we also have another thing that's very controversial
in the literature, and that's a disorder referred to as second-impact syndrome.
This apparently only happens in younger people. There are two recorded cases
of people over the age of 21 who have had this injury, and all of the rest
are below 21. Now it's not a great deal of cases. These are about 30 or 35 cases.
And they are case studies, so there hasn't been a controlled study on this issue.
So there is some controversy as to whether it actually exists or not, but these
are the people that have a mild head injury and then within hours or a few days
have a second mild head injury on top of it. And this is characteristic of
violent sports or contact sports, where you see it the most. This would be in
football players, for example, is where we find many of these injuries.
And we believe it's due to the fact that once you have a mild head injury,
it takes you time to recover, to get back to normal glucose utilization and so on,
this 5- to 10-day curve. And the person is getting their injury before their brain
has had a full chance to recover. Why it may be happening in children
more than adults it that their brain may in fact be more vulnerable based on
the model I just talked about with mice, that it takes longer for the brain
to get back to normal. And this makes sense on another practical level
with regard to sports injuries. That is, for example, if you strain your knee, the ACL,
you know that coaches on the sidelines or at basketball games when they
get a sprained knee, they take players out of the game. They don't let them
play through that injury, which is kind of typical of athletes--they like to play through
things and play through that pain. They pull them out of the game, because they know
if they have a strained knee they are vulnerable to that knee, in fact, having a much more
severe injury associated with the second injury on top of it. And I think we're dealing
with similar types of dynamics here.
Produced by Vicky Youcha and Brian King BrainLine.org.
Jeffrey Barth, PhD, ABPP-CN holds the position of professor and co-director of the Neurocognitive Assessment Laboratory, and section head, Neurocognitive Studies in the Department of Psychiatry and Neurobehavioral Sciences, with a joint appointment in the Department of Neurological Surgery at the University of Virginia School of Medicine.
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Related Content
Audio/Video:
Dr. James Kelly is professor of Neurosurgery and Physical Medicine and Rehabilitation at the University of Colorado Denver School of Medicine and associate director of the Colorado Area Health Education Center System. This is BrainLine's exclusive interview with Dr. Kelly recorded on July 11, 2008. Transcript of this video.- Dr. James Kelly Talks About Second Impact Syndrome
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