Second Impact Syndrome: Rest and Removal from Play

Although other treatments for second impact syndrome are being studied, the two hallmark treatments now are rest and removal from play. They should not be underestimated.

[Dr. Geoffrey Ling] So, SIS is a very serious condition. It's when the brain gets injured before it's had a chance to fully recover. And when that happens, it will respond very aggressively to the injury. It's not dissimilar to the analogy I gave you before. If you strike your thumb, not very hard, with a hammer and your thumb kind of swells up a little bit and aches, hit it a second time, and you'll practically come out of your skin. And that's the same thing that happens in SIS. The brain just reacts dramatically to the point where there's 50% mortality so it's very critical to avoid that second injury. So because of that, the rest and removal of play become two very prominent aspects of the "treatment" of traumatic brain injury. Then after that, it is really just supporting the physiology. Make sure there's plenty of oxygen; there's good blood flow to the brain and the like. At the very severe end, you could potentially do surgery, but for a mild concussion, the hallmark still is preventing further insult and also allowing the brain to rest. People are looking at other things such as cognitive exercises and some other unique kinds of non-pharmacologic, non-drug therapies such as biofeedback and the like. All these things are still unproven. They're promising. I truly, as a doctor, hope that they work, and I'm waiting with bated breath. But right now, you're exactly right. The rest and removal from play are the two hallmarks of managing concussion, but they should not be underemphasized. They are very restorative. Allow the body to take care of itself. The body does a good job.
Posted on BrainLine January 15, 2013.

Produced by Noel Gunther, Ashley Gilleland, and Erica Queen, BrainLine.