Researchers from St Michael's Hospital in Canada found that during 64 games, 61 players had 81 head collisions in 72 separate events.
Health care personnel assessed the player in 12 cases (15 per cent), 45 players (56 per cent) received assessment from another player, referee, or personnel on the field, and 21 players (26 per cent) received no assessment.
Of the 67 occasions in which players manifested two or more signs of concussion, 16 per cent received no assessment and returned to play immediately.
"Soccer players presenting signs of concussion following a head collision event deserve assessment from independent health care personnel to avoid delay of care or further injury. Assessment and management of soccer players suspected of concussion should be improved," said Michael Cusimano from St Michael's Hospital.
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Researchers examined the incidence, characteristics, and assessment of head collision events during the 2014 FIFA World Cup.
Trained reviewers identified head collisions through observation of video footage of all 64 matches of the tournament.
Observable effects of the collision on the player (slow to get up, disoriented, obvious disequilibrium, unconsciousness, seizure-like movements, head clutching) were documented as potential signs of concussion.
The study was published in the journal JAMA.
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