When it first emerged that Karius had been sent to get tested for concussion by the club I, like many others, thought it was an exercise in detoxifying his reputation after his disastrous display in the Champions League final. However, after reviewing the footage of the incident between Ramos and Karius and reading numerous expert opinions I've become far less cynical on the matter.
Although the footage of the collision isn't especially clear it does appear to show the right elbow of Ramos making contact with the left temple of Karius. This detail may be important because the temple is one of the thinner regions of the skull meaning an impact there could have a greater effect on the brain than an impact on other regions of the skull. If we strip away all the emotional baggage of the final and just judge the incident on the facts we know at this stage it does put what happened with Karius in the second half in a different light:
- We can see there was a collision between Ramos and Karius.
- We can see Karius was hit in a particularly vulnerable part of the head.
- A medical doctor has stated Karius showed signs of concussion FIVE days after the match when examined.
In fact, it's worth reading the whole statement released by the hospital, with the blessing of Karius:
“On May 31, 2018 Mr. Karius underwent a comprehensive examination by Dr. Ross Zafonte and Dr. Lenore Herget in Boston at Massachusetts General Hospital and Spaulding Rehabilitation Hospital. After carefully reviewing game film and integrating a detailed history – including his reported present and immediate post-contact subjective symptoms – physical examination and objective metrics, we have concluded that Mr. Karius sustained a concussion during the match May 26, 2018. At the time of our evaluation, Mr. Karius’s principal residual symptoms and objective signs suggested that visual spatial dysfunction existed and likely occurred immediately following the event. Additional symptomatic and objectively noted areas of dysfunction also persisted. It could be possible that such deficits would affect performance. We also note that Mr. Karius has reported significant and steady improvement since the concussive event, and we expect him to make a full recovery based on the results of the examination. We expect that with treatment and by following prescribed activity protocols he will continue to improve. We have encouraged vigilance and an emphasis on safety in his eventual return to full activity.”
Keeping what the doctors have said in mind it's worth considering the experiences of former goalkeeper David Preece:
"Most players will do anything to make sure they are fit for selection. To ensure that, injuries are masked or ignored due to the risk of another player taking their place in the side. “I’m alright,” is the lie you tell the medical staff, with your fingers crossed behind your back in the hope that you will be.
The older you get, the better you get to know your body. What injuries you can play with, which ones you need to rest, which ones you leave in the hands of the physios and doctors.
Concussion, though, is less straightforward. The spectrum of symptoms, their effects and whether you are actually aware of them at the time are wide and varied. Not all concussions are the same.
Yes, some you can recognise yourself. In a clash of heads with Livingston’s Marvin Andrews, my vision took on a misty frame, almost like a dream sequence in a film. Whilst at Silkeborg in Denmark, I fell awkwardly after taking a high ball and landed upside down and immediately felt drowsy, just wanting to go to sleep. Other times I’ve been totally unaware.
My first was as innocuous as they come. It was at Celtic Park in 1999. Mark Viduka came through on goal and rounded me with the ball before scoring in to the empty net behind me. As I dived at his feet, his knee glanced my temple. Looking back at the footage, I didn’t go down or even look for attention. To all intents and purposes, I was fine.
Now, I have to look at the footage to see what happened because to this day, I can’t remember. I was told by teammates I asked them if I’d had a knock to the head. They then informed the club doctor in the dugout, who then came to assess me. By this time it was only minutes from the end of the game, which I finished, totally bemused.
In the dressing room I repeated “Have I had a bang on the head? What was the score?” over and over. At that point, I couldn’t remember the previous 24 hours and was taken to hospital where I was diagnosed with concussion and post-traumatic amnesia. It was a state I stayed in for 48 hours, suffering from short-term memory loss. I was released but ordered not to undertake strenuous exercise for three weeks and no contact sport for six further weeks.
It should have been a warning for me but, wrongly, I treated head injuries like broken bones and muscular injuries. They became badges of honour and it was only after my fifth and the symptoms became longer lasting that I began to sit up and notice, reading up on the links to depression and early onset of dementia. By then it was probably too late.
The last incident in December of 2012 left a lasting impression, causing great concern. For two weeks after the incident, watching TV became unbearable. The moving pictures and any flashing images induced an intense nausea, so much so I’d vomit.
At the time and in the immediate aftermath of the Champions League final, Karius obviously didn’t outwardly display any signs of concussion but his late diagnosis and subsequent treatment is still vital not only to his physical recovery, but also mentally. I’m sure he won’t be using it as an excuse for what happened, but it may help in easing the self-flagellation and beating himself up that inevitably occurs after such errors."
So, given what we now know, there is little doubt Karius was experiencing some degree of concussion when he made those awful errors. We can't say how much it contributed to those errors but it was almost certainly a factor. No-one is seriously saying the game should be replayed, apart from the odd delusional fan, but given the information that is now available it would be unfair if we, as Liverpool supporters, didn't update our opinions on the keeper.