SECOND IMPACT SYNDROME

Zackery doesn’t want others to end up like him.  At 22, he walks with a looping gait, leaning heavily on a metal cane. He peers through thick glasses, specially designed to help his peripheral (side) vision. It takes him a moment to gather his thoughts before he speaks in a strained, thick voice. He struggles to remember his schedule day to day, and often relies on his mother to be his short-term memory schedule.

Zack’s daily challenges stem from a traumatic brain injury he received while playing football when he was 13. In 2006, Zack nearly died after he got two concussions in a single football game, something called second impact syndrome.

Although it’s not easy for him to get around, he’s spent the last 9 years speaking to lawmakers, coaches, athletic directors, trainers, health care workers, and parents about the dangers of concussions and what happens when they aren’t given time to heal.

That’s why it was especially painful for Zack to watch the news about Kenney; the 17-year-old high school football player from Seattle who died earlier this month, 3 days after he received a head injury during a game.
After his death, school officials revealed that Kenny, a wide receiver and defensive back, had suffered a concussion in September and had been cleared to play by health care professionals following the CDC’s guidelines. 
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Had Zack sat out the rest of the game on Oct. 12, 2006, he most likely would be doing normal 22-year-old activities, like “out driving picking up chicks,” as he likes to joke.

On that day, Zack suffered a concussion in the second quarter of the game when he made a tackle and hit the ground hard. He sat out for a while, but returned to the game in the second half.  Zack took more hits but finished the game. As he walked off the field with his father, he collapsed and started to convulse. He was flown to Seattle’s Harborview Medical Center and came within an hour of dying from a catastrophic brain injury, says Richard G. Ellenbogen, MD, the hospital’s chief of neurological surgery.

Second impact syndrome can happen within minutes, hours, days, or weeks after an initial concussion. It leads to dangerous brain swelling and bleeding, because the brain hasn’t recovered from the initial concussion.
A concussion happens when the brain shakes inside the skull. As the soft brain gets slammed against the skull’s uneven and rough interior, the friction stretches, strains, and tears the brain’s threadlike nerve cells, and can affect the blood vessels to cause bleeding and clots. It can cause confusion, disorientation, memory loss, seizures, slurred speech, and dizziness. Most concussions don’t make you lose consciousness, which is why sometimes people may be unaware of the seriousness of a head injury.

Zack "had blood clots on each side of his brain and suffered a series of strokes. The blood couldn’t flow, it was sort of strangulating his brain,” Ellenbogen says. During surgery, doctors removed his skull bone plates to relieve pressure caused by the bleeds in his brain.   While rare, second impact syndrome is so devastating that young, healthy patients can die within a few minutes, according to Robert Cantu, MD, clinical professor of neurosurgery at Boston University School of Medicine.

Doctors couldn’t tell Zack’s parents with any certainty what would come next. He was on life support for 7 days, in a coma for 3 months, didn’t speak for 9 months, and didn’t move a leg or an arm for 13 months. He used a feeding tube for 20 months, and it took 4 years until his right leg moved purposefully.

Zack’s message is simple: Treat concussions like a fractured bone that must be allowed to heal. Don’t "shake it off" -- standard practice not too long ago. Don’t fool yourself, or your coach, into thinking you are okay to play.
“You have to treat head injuries seriously,” Zack says. “You could end up like me or you could end up dead.”