“Second Impact Syndrome” refers to mild brain injuries suffered repeatedly within a short period (hours, days, or weeks). Although all brain injuries are serious, second impacts can be catastrophic or even fatal. The American Academy of Neurology has developed guidelines  for deciding when it is safe to return to play after a first injury. The Academy recommends that, to reduce the risk of the second impact syndrome, an athlete who suffers a head injury resulting in temporary confusion, amnesia, or other alteration of mental status should not return to play until examined by a health-care provider familiar with these guidelines. Sport oversight committees such as California Interscholastic Federation, have begun to adopt these recommendations.

The guidelines rely in part on self-reporting by student athletes or close observation by coaches and other players. Unfortunately, athletes are often reluctant to admit their injury. To prevent their child athlete from suffering a second impact catastrophe, parents should do the following:

• Know and recognize the symptoms of a brain injury. As described here.
• Learn what the coaches know about brain injuries.
• Find out whether the school has policy for handling brain injuries.
• Educate your child about the catastrophic risks of a second impact and
• Emphasize to your child the danger of hiding even the seemingly minor symptoms of brain injury.