CC BY-NC-ND 4.0 · Current Research: Concussion 2017; 04(01): e55-e57
DOI: 10.1055/s-0037-1607223
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The First Reported Case of Second Impact Syndrome: A Reexamination of Dr Fekete's Case Report from 1968

K. E. Gordon
1   Division of Pediatric Neurology, Department of Pediatrics, Dalhousie University and IWK Health Centre, Halifax, Nova Scotia, Canada
› Author Affiliations
Further Information

Publication History

23 September 2016

24 August 2017

Publication Date:
29 September 2017 (online)


Background In the December 28, 1968 edition of the Canadian Medical Association Journal, Dr John Fekete described a 16-year-old hockey player with fatal cerebral edema following a brain impact while actively symptomatic of a concussion incurred 4 days ago. This case has been described as a “possible” case of second impact syndrome, an entity that was named in 1984 and purportedly first described by Schneider in 1973.

Method An audit of material in the public register of Dr Fekete's case was undertaken. Information sources included the newspaper report of the death, transcripts from a coroner's inquest held 12 days later, including the autopsy report, genealogical data available online, and available internet resources.

Results There was clear documentation of concussive symptomatology following an initial head injury and evidence of a medical assessment, thus fulfilling the “definite” clinical criteria for second impact syndrome as proposed. After 4 days of ongoing concussive symptomatology, a dramatic, rapid neurological deterioration took place following an apparently unremarkable body contact and fall on the ice while playing hockey. His primary brain pathology included cerebral edema.

Conclusion Cerebral edema may follow primary or secondary head injury, the latter comprising second impact syndrome. Dr Fekete's case, as described in the December 28, 1968 edition of the Canadian Medical Association Journal, should be recognized as the first description of this condition.

Financial Disclosure

The author has no financial relationships relevant to this article to disclose.