By Mike Collett
LONDON (Reuters) - France international goalkeeper Hugo Lloris was given the all-clear to resume playing by Tottenham Hotspur's medical staff despite briefly losing consciousness against Everton on Sunday, the Premier League club said.
Lloris's head collided with the knee of Everton striker Romelu Lukaku in the 78th minute of their goalless draw at Goodison Park and Spurs have been widely criticized for their decision to allow him to continue.
FIFA's chief medical officer Jiri Dvorak and a spokesman for the brain injury charity Headway have both said he should have been replaced and not allowed to return to action after the incident.
Spurs posted a flurry of tweets after being stung by the criticism saying: "The club can confirm that Hugo Lloris underwent a precautionary CT scan and was given the all-clear and traveled back to London last night."
They also tweeted: "Hugo was cleared to resume playing after examination by the club's medical team."
However, Dvorak told British that FIFA's guidelines state that if there is any doubt about concussion then the player should have been taken off.
Dvorak said there was a "99 per cent probability" that Lloris would have been concussed after being knocked out when Lukaku's knee hit him and the Everton striker needed ice on his knee afterwards.
"The player should have been substituted. The fact the other player needed ice on his knee means it's obvious the blow was extensive," Dvorak said:
"It's a 99 per cent probability that losing consciousness in such an event will result in concussion."
Dvorak added whatever Lloris thought he could do should not have been taken into account.
"When he has been knocked unconscious, the player himself may not see the reality. I do not know the details but I know that the Premier League doctors are extremely good and I can imagine that the doctor may have recommended he be replaced.
"We have a slogan: if there is any doubt, keep the player out."
Spurs boss Andre Villas-Boas said he made the decision for Lloris to continue after taking advice from the medical staff but a spokesman for the brain injury charity Headway said the club showed an "irresponsible and cavalier attitude" to Lloris's health by allowing him to play on.
"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," Headway spokesman Luke Griggs said.
"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.
"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."
"It was a big knock but he looked composed and ready to continue," Villas-Boas said after the match. "Hugo seemed assertive and determined to continue and showed great character and personality. We decided to keep him on based on that.
"The call always belongs to me. Brad (Friedel) was ready to come in but the person Hugo is, there were enough signs for him to continue."
Griggs, however, was not impressed.
"Sports science has evolved significantly over the past decade and yet we're still faced with the antiquated concept that a player should be brave and try to continue at all costs," he said.
"Mr Villas-Boas's comment that his player's determination to play on was proof of his 'great character and personality' is simply wrong and dangerous."
Initially Lloris seemed as if he was going to be carried off on a stretcher to be replaced by substitute Friedel.
There was a four-minute delay -- which contributed to nine minutes additional time in all - but Lloris indicated he was ready to play on.
Although the collision appeared to be accidental, Lukaku was booked for the challenge and his knee was iced when he came off shortly afterwards.
Spurs captain Michael Dawson told the BBC he thought Lloris was going to go off.
"He took a really bad whack and I was worried when he went down and stayed down. When he got up his legs gave way but he stayed on and made two good saves," Dawson said.
"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. He's a little bit dazed but he's a lot better."
(Editing by Amlan Chakraborty and Pritha Sarkar)