Controversy
The existence of SIS is in question and is somewhat controversial. The sudden collapse seen in sufferers may be due to a type of cerebral edema that can follow an initial impact in children and teenagers, rather than to SIS. This type of edema, referred to as 'diffuse cerebral swelling' may be the real reason for the collapse which young people sometimes experience and which is commonly thought to be due to SIS. Those who doubt the validity of the diagnosis cite the finding that diffuse cerebral swelling is more common in children and adolescents as an explanation for the greater frequency of SIS diagnoses in young people. One group found that of 17 previously identified cases of SIS, only 5 met their diagnostic criteria for the syndrome, with some cases not clearly involving a second impact. They found that diagnoses of SIS were frequently based on bystander accounts of previous injuries, which they showed to be unreliable. Teammates of players who are thought to have SIS may overreport the initial concussion, giving the appearance of a greater number of second impacts than actually exist. Thus critics argue that the small number of reported cases leaves the question of whether SIS really causes the brain to swell catastrophically unanswered.
Whether a second impact is really involved in the diffuse cerebral swelling that occurs on rare occasions after a mild traumatic brain injury is controversial, but experts agree that such catastrophic brain swelling does occur after a very a small number of mild brain injuries and that young age is associated with increased risk. It is also agreed that some people may be particularly vulnerable to catastrophic brain swelling as the result of multiple head injuries.
Read more about this topic: Second-impact Syndrome
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