Second Impact syndrome? A review of Tua Tagovailoa's recent football injury

If you are a football fan, you have likely heard about Tua Tagovailoa's recent football injury.  Watching the replay of his injury was heartbreaking in both the intensity of the hit and the immediate side effects.  Our hearts go out to him, and we hope he will have a full recovery.  

When we witness an incident like this, we can't help but wonder if his most recent injury would have been less severe had he not returned to play after the head injury he sustained a week prior.  Though we can never know this answer definitively, airing on the side of caution is best.  

While we do strive to return athletes to their sports as soon as they are healed from concussion, we are always mindful of the risks were they to return too soon.  These risks can include, among others, second-impact syndrome, a significantly prolonged recovery, or exacerbation of preexisting or development of new neurologic or mental health conditions.  It's simply not worth the risk.  To be cleared from a concussion, we require the athlete meet 4 milestones, helping us feel confident the brain has healed: 1. normal neurologic exam (including cranial nerve assessment, eye tracking, and balance assessment), 2. resolution of symptoms with full academic participation and light exercise (without contact) participation, 3. return to his/her cognitive norm as evidenced by passing a standardized cognitive test, and 4. completing a 4-5 day return to play exercise progression without return of any concussion symptoms.  

The take-home message for all athletes is: if a hard hit is sustained that causes ANY concussion symptoms, even if they only last for a few seconds, STOP play and report the symptoms so that evaluation can be done, and continued play will not result in another hit, potentially with catastrophic consequences. 

To understand more about Tua's injury, Dr. Brian Sutterer explains in this excellent YouTube video.  Watch here: https://www.youtube.com/watch?v=pPZ0dYKM-t0