Gary Mihoces

USA TODAY Sports

NEW YORK — An NFL-hosted "think tank" on concussions has drawn medical representatives from national and international sports agencies, including soccer after FIFA received criticism for its handling of concussions during this summer's World Cup in Brazil.

"We are not alarmed. The situation is about the same over the past 16 years with a drop (in concussions) in 2006 when we introduced red card (match disqualification for an elbow to the head)," Jiri Dvorak, chief medical officer and chairman of the medical and research center for FIFA (Fédération Internationale de Football Association), said Monday.

But Dvorak did address the issue of who gets the final say on whether a player should be removed from competition due to a concussion.

"There is a controversy about overruling the decision of the team doctor," he said. "From FIFA's side, we will strengthen the position of the team doctor, as we did already in the past."

Dvorak cited a recent editorial by FIFA President Sepp Blatter in FIFA Weekly. Dvorak said Blatter wrote that the doctor has the "last word" in the concussion decision.

"So we will go into this direction of strengthening the position of doctor," said Dvorak. "That's for sure, improving the education … and also raising the awareness for the coaches and also for the players."

In the World Cup final, German midfielder Christoph Kramer continued playing for 14 minutes in the first half after taking a hit to the face against Argentina, according to a report from the Associated Press. Kramer was replaced after slumping to the ground, and he was helped off the field. The German football federation said he had a suspected concussion. A Uruguay player took a knee to the head in one match and lay flat and motionless on the field. He returned to the match.

Dvorak did not address those incidents specifically, but said: "You have to appreciate the situation we had at the world Cup. We had 36 cameras around the pitch. So the spectators are seeing with 36 eyes certain events, and it is not appropriate to make assumption or diagnosis based on TV images."

Dvorak said FIFA "very carefully" monitors concussion data.

"We have ... very good, detailed information about the past 66 FIFA competitions since 1998 ... the World Cup male and female. So we know pretty much the incidence of concussions," he added.

Dvorak claimed the incidence of concussions at FIFA events is 1.61 per 1,000 playing hours.

"It's about the same for the World Cup, the under-20, for the under-17 male and female. The female are slightly more prone to concussion than male," he said.

Helmets are a key point of focus for American football. The research consensus is that helmets protect against skull fractures and bleeding on the brain but don't prevent concussions. Research continues to develop better U.S. football helmets designed to curtail concussions.

Dvorak echoed that when asked if soccer has considered helmets.

"You can protect from fractures, but the fractures are extremely, extremely seldom in soccer," said Dvorak.

"We have done a number of studies ... on head bands, helmets in soccer, experimental studies. And the results were actually unanimous that it will not prevent the concussion forces in football … what you call soccer," said Dvorak.

The two-day meeting was held at NFL headquarters on Park Avenue. The session was closed, but some representatives met with the media afterward Monday.

***

Follow Gary Mihoces on Twitter @ByGaryMihoces