Dazed & Confused - How the World Cup was a disaster when it came to head injuries

Hats off to Germany. They were the best side throughout the World Cup, and deservedly won what has to have been one of the best tournaments to date. There were some extraordinary games in Brazil between 12 June and 13 July, not least the eventual winners 7-1 thrashing of the hosts. Other classics were Nigeria 2, Argentina 3 and Germany 2, Ghana 2, though of the England team, perhaps the best thing to do is say that young players like Raheem Sterling and Daniel Sturridge showed that we might just have a decent future.

But if Brazil 2014 will go down in history as a great and memorable World Cup, it could have been etched in our minds for the wrong reason. I refer not to what might have happened if Luis Suarez had longer teeth, but to the scant understand shown by match officials and administrators of the dangers of head injuries.

Potentially terrible consequences

Three serious incidents occurred in Brazil which could have had terrible consequences for the players involved. The first came when Uruguay beat England 2-1. Álvaro Pereira, the Uruguay defender, was knocked out in a collision with Sterling's knee. As The Times reported: "The Uruguay medical team were seen calling for his substitution, only to be overruled by the player, underlying their helplessness as occupational health physicians."

Next came Argentina's semi-final win over Holland. The superb Javier Mascherano clashed heads with Georginio Wijnaldum towards the half hour mark and showed clear signs of concussion, wobbling on his feet before slumping to the pitch. In spite this, he was allowed to play on.

Then came perhaps the worst incident of all, played out for all the world to see in the final. Christoph Kramer found himself in Germany's starting line-up (making his competitive debut for his country) after an injury in the warm-up to midfielder Sami Khedira. Early into the game, the young player's head smashed accidentally into an Argentinian player. Kramer was visibly disorientated, but was allowed to play on by Germany's medical staff. Fourteen minutes later, he fell to the ground, and was then substituted.

Boorish Lawrenson

Kramer has subsequently said that he couldn't remember anything of the first half the game. He looked awful as he left the pitch, eyes glazed and with a look of 'where am I and what is happening?' etched all over his features. His departure made for a telling counterpoint to the boorish, old-school tough guy commentary of the BBC's Mark Lawrenson, who was persistently sarcastic at players' injuries throughout the tournament and objected to the Argentinian players calling - sportingly - for the ball to be put out of play when Kramer lay stricken. Lawrenson further demonstrated an apparent ignorance of what happens with head injuries when saying, as Kramer groggily waited to come back on, "He's fine. He's jogging round the pitch now."

Thankfully, albeit that he was taken off looking anything but fine just under quarter of an hour later, Kramer does seem to be fine. So, too, was Tottenham goalkeeper Hugo Lloris, despite playing on after a head injury last November. Likewise, we hope, Pereira and Mascherano.

But here's the rub: when it comes to head injuries, we just don't know what damage may have been done. And a minute or two of pitchside assessment, when a player has been knocked out or is as visibly awry as Kramer, is woefully inadequate.

Fifpro, the world players' union, has rightly criticised Fifa for failing to protect the players upon which its tournament depends. The union predicts "a tidal wave [of compensation claims] that will engulf" professional football, unless a protocol regarding concussion is adopted as part of the rules of the game. Radically, and yet sensibly, Fifpro also calls for a review of the laws of the game to compensate a team if it goes down to 10 men while a head injury is being assessed.

Prevention is better than cure

And assessment is crucial. We don't want professional football to end up like the NFL in the United States, or the NHL, where significant class action litigation over head injuries is now a fact of life. Not because of bogus objections to people suing for compensation, but because we don't want to see people needlessly injured. The fact is that a head injury can be fatal; it can lead to Second Impact Syndrome, when a later blow on top of the first one leads to brain damage or death.

Proper attention to head injuries is vital. It is essential that Fifa and the game's national governing bodies around the world take action to ensure that prevention is better than cure - for the fundamental reason that when it comes to a head injury, there may well not be a cure.

Let's give thanks to the continuing recovery of Christoph Kramer and his colleagues - and pray that a professional football match is not one day the scene of a fatal head injury because of governing body negligence.