Abstract
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.
Keywords
second impact syndrome - brain concussion - child
