Concussion – Complications

By Michael Yorio, MD

Some Possible Complications of a Concussion

Similar to other types of injuries, the best predictor of subsequent concussion is a history of at least one concussion. Among collegiate football players, patients who self-reported 3 or more concussions were 3.5 times more likely to sustain a subsequent injury than players with no concussion history, whereas those with 2 concussions were 2.8 times more likely. An increased risk for subsequent concussions in high school athletes with a history of concussion has also been reported. In a prospective investigation, football players with a concussion history were nearly 3 times more likely to sustain another injury, whereas non-football players were 1.2 times more likely. Therefore, current recommendations suggest that modifying factors including repeated concussions over time, multiple concussions within a short time frame, sustaining concussions with lessening force, or increasing severity of injury, should result in a more conservative management approach. Proper management of a concussion will reduce the risk of a repeat injury.

  • Second-Impact Syndrome

  • A primary concern of returning to play too soon by pediatric athletes is second-impact syndrome, or malignant cerebral edema, which occurs after a second impact while the patient is still symptomatic from a previous injury to the head or body. The condition is characterized by diffuse cerebral swelling with catastrophic deterioration. Many athletes that suffer from second-impact syndrome never recover to full health.
  • Click here to read more about second impact syndrome
  • *Information adopted from National Athletic Trainers’ Association Position Statement: Management of Sport Concussion.


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