engleski

Second-impact Syndrome has some Hypersensitivity Traits Suggesting Need for Reconsideration of Hypersensitivity Classification

BACKGROUND: Motivated by the resemblances between second-impact syndrome and re-exposure to a specific type of antigen, what was additionally encouraged by comprehensive discussion following case presented by Veevers et al. (2009) we re- question the nature of a controversial term pertinent to mild traumatic brain injuries (mTBI). Fatal brain swelling after a second concussion prior to the subsiding of the earlier one’s symptoms roughly corresponds to some undesirable, but normal reactions of the immune system. Even we opine that proven and known mechanisms of neuronal edema in concussive and ischemic injuries as reviewed by Giza et al. (2001) would severely diminish a space for a “new, " obscure and anecdotal SIS, we advocate new approaches to questions with widespread implications in sports medicine, neurology, neurosurgery and forensic medicine. And possible localization of antigen-specific IgE and mast cells within brain tissue could explain a local release of a variety of active agents into the surrounding tissue what would cause local anaphylaxis. This is a locally limited example of a life-threatening response that can lead to a collapse of the circulatory and respiratory systems. MATERIALS AND METHODS: A systematic review was conducted to search for studies which investigated the nature of brain swelling in the second concussion. We used two outcome measures as possible of explanation hypersensitivity and second-impact syndrome. Three databases (Pubmed, Scopus and Google Scholar) were searched for publications between January 2000 and April 2016. The Boolean search terms used were: [‘hypersensitivity’ AND ‘second * syndrome’]. RESULTS: The search generated a total of 1181 studies. Titles, abstracts and keywords were reviewed to determine if studies could be included. Where these did not contain sufficient information, the paper itself was reviewed. Inclusion criteria were: original journal papers, human participants and papers written in English during the above timespan. Following a review of titles, abstracts and keywords, 27 studies were considered for inclusion, and review of full papers followed to confirm that inclusion criteria were met. CONCLUSION: Perhaps we are placing too much emphasis on a “first impact” that is largely based on eyewitness accounts ; unreliable diagnostic criteria, i.e. the number of spectators at collegiate vs. high school, or practice vs. game. Furthermore, a report by Duhaime et al. (2012) concluded that 17/31 cases of sport-related concussion across collegiate hockey and football players recalled no specific impact.No matter whether considered entity sui generis, or "diffuse cerebral swelling" recognized as the complication of traumatic brain injury (TBI), it is impossible not to note the striking similarities between massive cerebral edema, loss of auto-regulation and the immune response. Just like the hypersensitivity reactions that require a pre-sensitized (immune)state of the host ; SIS, considered by many controversial, also presumes “memorizing” capability of the injured brain. Impressiveness has been constantly tipping the scales of anaphylaxis towards the respiratory group of signs, what does not exclude an entirely new line of neurological substrates for anaphylaxis. Accordingly, by analyzing 50 anaphylactic deaths, Barnard (1967) recognized in some cases the existence of an apparent cerebral response to the antigen. The impressive cerebrovascular engorgement and eventual brain herniation, occurring in a matter of minutes, could correspond to a reaction provoked by re-exposure to a specific type of antigen. If the premise of diffuse cerebral swelling is granted, a new area for the analogy with immune response unfolds.

Second-impact Syndrome

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