D.C. United defender Steve Birnbaum came on at halftime of today’s United States friendly with Cuba for John Brooks and was having a good second half, or at least as much as one could expect against the 139th ranked team in the FIFA rankings. With the score 0-0, he even made a deflection that appeared to prevent Cuba from taking the lead over a lackluster USMNT.

Then in the 80th minute, Birnbaum suffered a kick to the head that, somehow, went uncalled. We say “somehow” because the referee, the fourth official, and the near-side AR are all looking squarely at Duxney Espinosa’s studs making hard contact with Birnbaum:

Cuba continued their attack against the suddenly short-handed USMNT, sending a golden opportunity over the bar. The broadcast then cut to Birnbaum down on the ground, clearly bleeding from the blow:

Moments later, a different angle only served to emphasize that Birnbaum had been caught by a leaping kick as he headed the ball. Birnbaum tried to run at first, but is clearly grabbing at what is in all likelihood a pretty ugly gash on his head.

Birnbaum went off the field to receive treatment and did not return for the final 10 minutes of the game. The US ended up playing out the final minutes down a man, having used the maximum six substitutes FIFA allows for friendlies.

This is not the first injury Birnbaum has suffered with the USMNT, having had aknee issue that kept him out of a game against Panama during friendlies at the beginning of 2015. This isn’t even the first time Birnbaum has suffered a head injury this year; he suffered a cut during the team’s regular season opening loss to the LA Galaxy, which led him to wear protective headgear to protect stitches as a result.

As of this writing, there has been no update on Birnbaum’s condition. There’s obviously a cut involved, and with any blow to the head it’s important to test for a concussion and monitor for any symptoms in the following days. The US will fly back from Havana soon due ahead of Tuesday’s friendly against New Zealand (coincidentally at RFK Stadium, Birnbaum’s normal stomping grounds).

If Birnbaum sits that game out, the question becomes whether he would recover in time to play with the Black-and-Red in their home finale against New York City FC on October 16th. D.C. has had several players miss time due to concussions suffered in training; Jared Jeffrey, Kofi Opare and Patrick Nyarko have missed games at varying points this year, and Chris Rolfe has yet to return since suffering a concussion in May. The list of players who have suffered concussions as DCU players and have had their careers shortened as a result is stark for anyone familiar with them. As such, there’s always going to be concern after such an incident.