Second-impact Syndrome - Prevention

Prevention

Measures that prevent head injuries in general also prevent SIS. Thus athletes are advised to use protective gear such as helmets, though helmets do not entirely prevent the syndrome.

Experts advise that athletes who have suffered one concussion and still complain of concussion-related symptoms be prohibited from returning to the game due to the possibility of developing SIS. Athletes are also discouraged from returning to play until after they have been evaluated and approved for resuming the sport by a healthcare provider skilled in evaluating concussion. Some athletes may deny concussion symptoms because they do not wish to be prevented from rejoining the game. Thus athletic trainers may prohibit return to play for any athlete who has suffered a concussion, regardless of the speed with which the symptoms reportedly resolve. An initial head injury may impair an athlete's judgment and ability to decide to refrain from participating in risky activity, so some healthcare providers encourage family members and other acquaintances to pressure an athlete not to return to play.

Several different sets of return-to-play guidelines exist for athletes who have suffered minor head trauma. These exist in part to prevent the player from developing SIS. A variety of concussion grading systems have been devised, in part to aid in this determination. Every return-to-play guideline recommends that an athlete not return to competition until all concussion symptoms are absent during both rest and exercise. The American Academy of Neurology recommends that young athletes be prohibited from returning to play for at least a week in most cases of concussion.

The current return-to-play guidelines may not be strict enough to protect young athletes from SIS. On the other hand, they may be too strict for professional football players; evidence that the syndrome exists in this population is lacking.