Second Impact Syndrome

Second Impact Syndrome and Prevention of Repeat Concussions

What is Second Impact Syndrome?

Second Impact Syndrome occurs when a person suffers a second concussion before the symptoms of the first one have subsided. Specifically, in this condition the brain swells rapidly and catastrophically. Sometimes, even fatally. At least 50% of people with Second Impact Syndrome die, and 100% are permanently impaired.

Once a first concussion had been sustained, the brain becomes much more sensitive to further damage. In fact, if the victim has not yet recovered from the first concussion, a shake, mild blow, or fall, even without a direct hit to the head, can start the process of Second Impact Syndrome. This is why WHEN IN DOUBT, SIT IT OUT is so important. If there is any possibility of a concussion, it is critical to avoid a second impact of any kind.

Preventing Second Impact Syndrome

Our athletic trainers work with local schools to establish and enforce a protocol requiring at least seven days off from contact sports following an initial concussion. This allows time for the brain to heal, reducing the risk for a second concussion. For this reason, Jenna’s Law, an extension of Max’s Law, legislated against immediate return to play after a concussion. The result is a marked decrease in the number of students developing Second Impact Syndrome. In fact, Second Impact Syndrome is now extremely rare, thanks to greatly improved concussion recognition and care.

Preston Plevretes - Real Life Story of the Devastating Effects of Second Impact Syndrome


If you believe your child has a concussion, you should seek medical attention from a concussion specialist. NOWcare at The Center, offers immediate concussion evaluation with no appointment. NOWcare is available MONDAY – FRIDAY, 9 A.M. – 4 P.M. with same day ImPACT testing, if needed. Click here for more information.

Next, Dr. Ugalde's weekly Friday Concussion Clinics at The Center offer support to those experiencing longer-term concussion symptoms. Call 541-322-2214 for more information.

In addition, if your child plays high school sports in Central Oregon, your high school athletic trainer is available during school hours. Find your high school athletic trainer HERE.

Get the support your child needs to safely recover from a concussion.


We are passionate about getting Central Oregon youth the care they need when they have experienced a concussion. To this end, we follow a research-based model of management in treating concussions. Like you, our focus is on getting your child healthy, and safely returning them to the activity they love.

Additionally, we strive to provide the most current concussion information on these pages. However, if you do not find what you are looking for here, please contact us.

The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. See our Terms of Use for more information.


Page References: 
Robert C. Cantu, SECOND-IMPACT SYNDROME, Clinics in Sports Medicine, Volume 17, Issue 1, 1998, Pages 37-44, ISSN 0278-5919, (

Martineau, Chad PA-C, ATC; Kingma, Jackie J. MS, ATC, PA-C, PT; Bank, Laura PhD, PA-C; McLeod, Tamara C. Valovich PhD, ATC Guidelines for treatment of sport-related concussions, Journal of the American Academy of Physician Assistants: May 2007 - Volume 20 - Issue 5 - p 22-28

Bey, MD, T., Ostick, MD, B. (2009). Second Impact Syndrome. West J Emerg Med. 2009 Feb; 10(1): 6–10.

Did You Know?

$76.5 billion - the cost of traumatic brain injuries in the United States.