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Concussion
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===Second-impact syndrome=== {{Main|Second-impact syndrome}} Second-impact syndrome, in which the brain swells dangerously after a minor blow, may occur in very rare cases.<ref>{{cite web |title=Second Impact Syndrome: the Dangerous Effect of Multiple Concussions |url=https://reverehealth.com/live-better/second-impact-syndrome-dangerous-effect-multiple-concussions/#:~:text=Second%20impact%20syndrome%20(SIS)%20occurs,rapid%20and%20severe%20brain%20swelling. |website=Revere Health |access-date=10 November 2022}}</ref> The condition may develop in people who receive a second blow days or weeks after an initial concussion before its symptoms have gone away.<ref name=Bowen03/> No one is certain of the cause of this often fatal complication, but it is commonly thought that the swelling occurs because the brain's [[arteriole]]s lose the ability to regulate their diameter, causing a loss of control over cerebral blood flow.<ref name=moser/> As the brain [[Swelling (medical)|swells]], intracranial pressure rapidly rises.<ref name=CookSchweer/> The brain can [[brain herniation|herniate]], and the brain stem can fail within five minutes.<ref name=Bowen03/> Except in boxing, all cases have occurred in athletes under age 20.<ref name=Team/> Due to the very small number of documented cases, the diagnosis is controversial, and doubt exists about its validity.<ref name="McCroryP01">{{cite journal | vauthors = McCrory P | title = Does second impact syndrome exist? | journal = Clinical Journal of Sport Medicine | volume = 11 | issue = 3 | pages = 144β149 | date = July 2001 | pmid = 11495318 | doi = 10.1097/00042752-200107000-00004 }}</ref> A 2010 ''Pediatrics'' review article stated that there is debate whether the brain swelling is due to two separate hits or to just one hit, but in either case, catastrophic football head injuries are three times more likely in high school athletes than in college athletes.<ref name=Peds2010/>
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