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Аннотация
Second impact syndrome (SIS) is a severe injury that primarily occurs in children and young adults engaged in various sports. It develops when a second concussion occurs before symptoms from the first concussion have resolved. The mechanism behind this phenomenon lies in diffuse and frequently catastrophic cerebral swelling and also involves intracranial hematoma, more specifically, increased acute subdural hematoma, brain herniation, and death. The term second impact syndrome was first suggested by Saunders and Harbaugh in 1984. However, the available information in the literature is still contradictory. Concussion is more functional rather than a structural pathology and neuroimaging studies are not needed in all patients with concussion. Yet, they should be performed whenever the symptoms associated with concussion persist. Available information regarding the treatment of SIS is scarce as cerebral herniation and death results quickly. If there is any suspicion of SIS, the patient should be immediately stabilized and neurosurgery consultation should be requested. Studies recommend proper intubation and Manitol administration. To prevent SIS, the athlete with the symptoms suggesting concussion should be prohibited from returning to play. In conclusion, more studies are needed to better charac- terize SIS. They should be directed at proper diagnosis and treatment of concussion and unified algorithm to identify potential risks for SIS and recommendations as to how and when the patient should return to play.
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