All's not well that ends well when there's a risk of serious brain damage. Spurs were wrong to let Hugo Lloris play on

"It's OK. I'm fine. I want to carry on."

These words are often heard by boxers when they've come round after a KO punch. Whether the fighter is out for just a few seconds, or a matter of minutes, his instinct is almost invariably to fight on.

In fact, the boxer's brain and nervous system have been scrambled so much that he doesn't even realise that the referee has stopped the fight. The minutes of unconsciousness are precisely that. They're lost forever. There's no getting the time back, there are no memories to retrieve. To be 'out cold' hints at just how much damage has been done by the KO blow: after all, we're at our coldest when we’re dead.

A disturbing response

As a lifelong football fan, only rarely have I seen head injuries of the kind that boxing fans often witness. But last Sunday's game between Tottenham Hotspur and Everton yielded one. And the way it was dealt with cannot but be disturbing.

Huge Lloris, the Spurs goalkeeper, was knocked out when challenging for the ball against the onrushing Everton striker Romelu Lukaku. To view the footage on YouTube is to see that Lukaku's knee clatters forcefully into Lloris's head. The velocity must have been easily the same as a boxer landing his best punch.

No wonder, then, that Lloris was rendered unconscious. There is doubt as to whether the goalkeeper lost consciousness completely or suffered a 'transient' alteration of consciousness but what is abundantly clear is that he took several minutes to recover. But astonishingly, and despite his French keeper's unsteady feet when he was finally able to stand up, the Spurs manager Andre Villas-Boas did not substitute Lloris. He had a very able deputy in Brad Friedel, but decided to let his injured goalkeeper play on - mindful, perhaps, of Football Association guidelines to the effect that a merely 'transient' alteration of consciousness does not mean a player cannot return to play.

Villas-Boas also elected to ignore the obvious concerns of his captain, Michael Dawson, who appeared to try to persuade Lloris to go off after he got to his feet. "He took a really bad whack and I was worried when he went down and stayed down," said Dawson. "When he got up his legs gave way, but he stayed on and made two good saves. I lead those boys but safety is the most important thing. He was in a bad way, but, by the time he came around, he was wanting to stay on."

All's not well that ends well

So, was all well that ended well? Hardly. Spurs' decision has rightly attracted much criticism, not least from the brain injury charity Headway. Its spokesman, Luke Griggs, had this to say:

"When a player - or any individual - suffers a blow to the head that is severe enough for them to lose consciousness, it is vital they urgently seek appropriate medical attention. A physio or doctor treating a player on the pitch simply cannot accurately gauge the severity of the damage caused to the player's brain in such a setting as there may be delayed presentation of symptoms." And yet more tellingly: "By continuing to play, the player may have caused greater damage to his brain. He should have been removed from the game immediately and taken to hospital for thorough tests and observation."

Headway chief executive Peter McCabe also commented on Spurs' decision here.

Happily for Lloris, it seems that subsequent scans show that he has emerged unscathed from the clash with Lukaku. But, quite rightly, the Professional Footballers' Association (PFA) says that players should be automatically removed from the pitch should they suffer "a severe trauma" to the head that causes a loss of consciousness. So, too, do players' union FifPro and world governing body Fifa.

Those calling for caution are correct. Spurs behaved in a cavalier fashion in letting their player continue. In such circumstances, just like a KO'd boxer, the decision is not the player's; it is the club's. The club should not have taken the risk of Lloris potentially being concussed and suffering serious brain injury.

In boxing, a KO'd boxer is not allowed to fight again for at least 28 days from the date of the KO. Villas-Boas could still set the right example by giving Friedel the nod and resting Lloris for 28 days. But the odds that this will happen must be very long indeed.