Your star player gets his bell rung, and staggers around for a few seconds before apparently stabilizing. You call him to the sideline, but he says he's okay, and he looks fine to you. You don't have much hope of winning the game without him, so you let him use his own judgment, and he runs right back into the game. After just a few minutes, he takes another bump on his head. It's just a little bump, not nearly as hard as the first one. But he starts walking toward the sideline shaking his head to clear it, and suddenly falls down. What do you do?
Yes, and do it as quickly and as urgently as you can. This may be a case of Second Impact Syndrome (SIS), in which a seemingly minor bump before the brain has recovered from a previous concussion may cause immediate swelling of the brain, with the skull putting huge amounts of pressure on it. If the pressure is not released quickly, the results can be catastrophic. SIS occurs very rarely, but when it does occur it has a mortality rate of about 50%, so it must be taken seriously. It is never worth the risk to allow a player to take an active role in soccer - either a game or a practice - until his brain has completely recovered from a prior concussion, and a neurologist has agreed that he is ready for physical activity again.
Wrong! Just because he looks okay and doesn't complain of any concussion symptoms doesn't mean he doesn't need medical attention. Any head impact shortly after a concussion is a potentially dangerous situation, and warrants quick attention. You made one mistake by letting him go back into the game after having his bell rung; don't compound the problem by ignoring a possible second concussion. The fact that the second hit was bad enough to cause him to falter as he walked off the field makes this a frightening situation that must be addressed with proper medical attention.
