JOHN DOHERTY: Second Impact Syndrome worth second thought

2013-05-20T18:00:00Z 2013-05-20T18:44:04Z JOHN DOHERTY: Second Impact Syndrome worth second thoughtJohn Doherty Times Columnist nwitimes.com
May 20, 2013 6:00 pm  • 

First, let’s be clear, Second Impact Syndrome (SIS) is extremely rare. I know of only one documented case in the last 25 years in Indiana.

Unfortunately, when it does occur, if it is not fatal it is permanently disabling.

SIS is almost exclusively suffered by teenagers, with 95% of documented cases among those 18 and younger.

It is theorized that the chemistry of the immature brain makes it susceptible to the syndrome. An initial concussion is thought to impair the brain’s ability to control intra-cranial pressure. Hit again before it has recovered, the brain swells uncontrollably.

Over the past 20 years, there have been an average of five cases per year nationwide — if that many — and each time the victim has been male.

That is, until perhaps two weeks ago and not in the United States but in Canada.

On May 8, 17-year-old Rowan Stringer of Ottawa was tackled during a high school rugby match and flew through the air, landing hard on her head and neck, according to CBC. She immediately sat up but then lost consciousness in seconds. Emergency surgery to reduce pressure inside her skull failed and she died on May 12.

Stringer’s family requested an autopsy and the results are pending but the teen’s history is classic for SIS.

She had been hit in the head during a game the week before and complained of a headache but her parents didn’t seek medical care, opting to treat her themselves with what CBC described only as a “pain reliever.”

On May 6, Stringer was hit in the head again during a game, telling friends but not her parents — one secret among teenagers that never should have been kept.

The case in Indiana was nearly identical, is relatively recent and was documented by Indianapolis physicians in the March issue of the Journal of Neurosurgery: Pediatrics. The strongest common thread between the two cases? A strong and persistent headache after a first hit followed by another hit to the head days later.

The only differences were the Indiana victim was male, was playing football instead of rugby and he survived. However, not before spending 98 days in the hospital during which he was resuscitated from cardiac arrest, had multiple surgeries and needed dialysis for kidney failure.

There one other difference: he saw a doctor. It was four days after his first injury for a lingering headache, a CT Scan was ordered and it was negative but the athlete was told not to play until he was symptom-free. He went back to practice the same day anyway.

Not identified in the Neurosurgery: Pediatrics article, Cody Lehe was named by numerous media outlets at the time of his injury and has been many times since.

Then a senior at Frontier High School, near Lafayette, Lehe experienced a big hit in a game on Oct. 20, 2006. With no athletic trainer on staff at the time — there is one now — he was allowed to return to practice on Oct. 24. A day later, he took what most describe as a light hit to one of his shoulders. Published reports differ as to whether or not Frontier was in full pads that day. No matter, Lehe went down to one knee several plays later and then lost consciousness. The rest is history.

Now, nearly seven years later, he has limited speech and is wheelchair bound.

John Doherty is a certified athletic trainer and licensed physical therapist. This column reflects solely his opinion. Reach him at ptatcsport@sbcglobal.net. Follow him on Twitter @JDohertyATCPT.

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