2026 Pediatric Orthopaedic
Self-Assessment Examination
,AAOS 2026 Pediatrics
Question 1 of 100
Second-impact syndrome following a concussion
1- poses minimal concern for morbidity or mortality.
2- is less common in adolescents than in adults.
3- is related to a disruption of cerebral autoregulation.
4- refers to a second head injury after the athlete has been medically cleared to return to
play.
PREFERRED RESPONSE: 3- is related to a disruption of cerebral autoregulation.
DISCUSSION
According to several consensus statements, no child or adolescent athlete with a
concussion should be allowed to return to play on the same day, regardless of severity. Second-
impact syndrome refers to a second traumatic head injury that occurs while an athlete is still
experiencing symptoms from the first injury. Young athletes are particularly vulnerable to
second-impact syndrome. The mechanism by which this syndrome occurs likely is disruption
of cerebral autoregulation, which may result in cerebral vascular congestion, diffuse brain
swelling, and death.
1
,AAOS 2026 Pediatrics
Figure 2 Figure 3
Figure 4 Figure 5
2
, AAOS 2026 Pediatrics
Figure 6a Figure 6b
Figure 6c
RESPONSES FOR QUESTIONS 2 THROUGH 6
1- Curettage and/or grafting
3
Self-Assessment Examination
,AAOS 2026 Pediatrics
Question 1 of 100
Second-impact syndrome following a concussion
1- poses minimal concern for morbidity or mortality.
2- is less common in adolescents than in adults.
3- is related to a disruption of cerebral autoregulation.
4- refers to a second head injury after the athlete has been medically cleared to return to
play.
PREFERRED RESPONSE: 3- is related to a disruption of cerebral autoregulation.
DISCUSSION
According to several consensus statements, no child or adolescent athlete with a
concussion should be allowed to return to play on the same day, regardless of severity. Second-
impact syndrome refers to a second traumatic head injury that occurs while an athlete is still
experiencing symptoms from the first injury. Young athletes are particularly vulnerable to
second-impact syndrome. The mechanism by which this syndrome occurs likely is disruption
of cerebral autoregulation, which may result in cerebral vascular congestion, diffuse brain
swelling, and death.
1
,AAOS 2026 Pediatrics
Figure 2 Figure 3
Figure 4 Figure 5
2
, AAOS 2026 Pediatrics
Figure 6a Figure 6b
Figure 6c
RESPONSES FOR QUESTIONS 2 THROUGH 6
1- Curettage and/or grafting
3
