Alvaro Pereira apparently knocked unconscious in Uruguay-England match, stays in against medical advice

Eric Freeman
Dirty Tackle
Uruguay's Diego Godin, goalkeeper Fernando Muslera and referee Carlos Velasco Carballo from Spain, from left, call for medical support as Uruguay's Alvaro Pereira lies on the floor during the group D World Cup soccer match between Uruguay and England at the Itaquerao Stadium in Sao Paulo, Brazil, Thursday, June 19, 2014
Uruguay's Diego Godin, goalkeeper Fernando Muslera and referee Carlos Velasco Carballo from Spain, from left, call for medical support as Uruguay's Alvaro Pereira lies on the floor during the group D World Cup soccer match between Uruguay and England at the Itaquerao Stadium in Sao Paulo, Brazil, Thursday, June 19, 2014. (AP Photo/Michael Sohn)

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It's every soccer player's dream to represent his country in the World Cup. Sometimes, however, that same desire can outweigh sounds medical advice.

In the 61st minute of Thursday's Group D match against England, Uruguay left back Alvaro Pereira took an inadvertent knee to the head from attacking midfielder Raheem Sterling. Pereira stayed motionless on the ground, seemingly unconscious, if not confirmably concussed:

Not surprisingly, medical staff immediately motioned for Pereira to get subbed out, a less-than-easy decision given that Uruguay were already playing without first-choice defenders Diego Lugano and Maxi Pereira (no relation). Yet Alvaro Pereira would have none of it:

Shockingly, his protests won out and he stayed in the match for the full 90 minutes of Uruguay's 2-1 win. Once it became clear that Pereira would not be taken out, Twitter lit up with criticism:

ESPN analyst Taylor Twellman, who has criticized MLS for ignoring symptoms of multiple concussions during his career, had strong words for the FIFA president:

As noted by writer Gabriele Marcotti, FIFA does have an impartial doctor at every venue to overrule team doctors and managers. It's unclear exactly what injury Pereira suffered in this case, but at the very least we have an uncomfortable moment in which an athlete appeared in danger and was not removed for safety purposes. The outcry is understandable, even with little information on the specifics.

American sports fans will be well familiar with concussion policies and controversies from the NFL, NHL, and even the NBA, but world soccer has had its own incidents recently. In November, Tottenham goalkeeper and French international Hugo Lloris stayed in a Barclays Premier League match after a collision with Everton striker Romelu Lukaku even though a team doctor and captain Michael Dawson pleaded for him to come out. That series of events sparked a great deal of discussion over proper protocols and became the first point of comparison after Pereira's failure to leave Thursday's match. No matter the bravery or pride on display — and these are admirable qualities — an athlete who's taken a blow to the head is never the person best-equipped to make a decision about his own status.

It's as yet unclear what will occur after this controversy, but such disregard for medical wisdom would appear to inspire new questions and points of conversation. Whether FIFA decides to take strong action is another question altogether.

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Eric Freeman is a writer for Yahoo Sports. Have a tip? Email him at efreeman_ysports@yahoo.com or follow him on Twitter!