Cerebral concussion is the most common form of sports-related traumatic brain injury (TBI), and the long-term effects of repeated concussions may include dementia, amyotrophic lateral sclerosis, and other neurological disorders, say the journal editors.
However, what was perhaps more concerning was that even when the symptoms of concussion were delayed, or came and went quickly, neurological damage could remain without detection. This could lead to footballers, such as Uruguayan defender Alvaro Pereira during the 2014 FIFA World Cup, overruling doctors' advice to be substituted and returning to play after sustaining a head injury.
The researchers argued that the decision for players to return to a game after sustaining a concussion should be made only by healthcare professionals and should surely be taken out of the hands of those with a vested interest in the player's performance.
They added that many sporting organizations were now acknowledging the potentially serious consequences of mild TBI and had drawn up new protocols to protect athletes who sustained a head injury.
An investigation of concussion protocols and return-to-play standards has been called by FIFPro, the world players' union following Pereira's injury.
The editorial is published in The Lancet Neurology.