Abstract
Introduction Post Concussion Syndrome (PCS) occurs when a patient who has sustained a concussion continues to experience symptoms after a seven to fourteen day period.3 It is estimated up to 40% of individuals who sustain a concussion will experience PCS.1,5,6,7,8,9,10 Second impact syndrome (SIS), a phenomena that may occur anytime during the recovery process of a concussion, is defined as an individual experiencing a second blow to the head while recovering from an initial concussion.12 Outcomes from a second impact vary greatly from increased symptoms to functional deficits such as decreased balance and use of limbs to even death.15 Case Patient A fifteen-year-old male presented to the clinic 10 days post initial impact presenting with a combination of cognitive fatigue, oculomotor deficits, and vestibular symptoms. The patient was feeling 100% back to normal when a second impact to his head occurred 24 days post initial impact. Following the second impact the patient again began experiencing concussion symptoms. At 61 days post initial impact, and 37 days post second impact, the patient was feeling 98-99% back to normal and was ready to begin a return to play program through his school. Discussion Though there is little evidence and research regarding SIS and the recovery from a second impact, this case report demonstrates two things: timing between initial impact and second impact may influence recovery and a second impact may cause the loss of or reversal of any recovery from the initial impact. Conclusion Further research is needed to gain a better understanding of how second impacts influence recovery from concussion.