Soccer: 2014 World Cup ignored concussion protocols, Toronto doctor says

An avid soccer fan, Toronto-based neurosurgeon Dr. Michael Cusimano gets concerned every time he sees a player stay on the pitch after showing symptoms of a head injury.

He decided to explore the issue at the game’s highest level, leading a research team that systematically examined the 2014 FIFA World Cup in Brazil. The results, published online Tuesday in the Journal of the American Medical Association, indicated international recommendations for assessing whether an athlete had suffered a concussion were not followed at the tournament.

“The concussions primarily occur with player-to-player contact in the vast majority of cases,” Cusimano said. “Our point with this is very simple. If somebody sustains something, they should be properly assessed. It should ideally be a doctor that properly assesses them. “It’s a very simple message.” The findings also left Cusimano, who’s based at St. Michael’s Hospital, concerned about the potential trickle-down effect on fans and young players involved in the sport.

“They set the tone for the culture,” he said of FIFA, world soccer’s governing body. “Let’s face it. When they have viewerships of over a billion people . . . it’s a global phenomenon.”

Cusimano’s team reviewed videotapes of all 64 games from the tournament. Researchers documented 72 concerning head collisions and affected 81 players.

Fourteen players (17 per cent) showed no sign or one sign of a concussion, 45 players (56 per cent) had two signs and 22 players (27 per cent) exhibited three or more signs, the review found. Among players with three or more signs, 19 (86 per cent) returned to play in the same game after an average assessment of just 84 seconds.

“To make a proper assessment is a cornerstone of managing people,” Cusimano said.

Guidelines that FIFA has adopted say that players showing any signs of concussion should be immediately withdrawn from play and assessed by sideline health-care officials.

Researchers found the average assessment at the World Cup lasted 107 seconds.

Based on the SCAT3 concussion evaluation system in use in 2014, a minimum of seven to 10 minutes would be required to do a proper assessment, Cusimano said.

“The longest assessment we saw was 180 seconds,” he said.