British and Irish Lions hooker Dan Cowan-Dickie was stretchered off in a neck brace in the first half of his side's clash with an AUZN Invitational side. With the Lions leading 17-0 at the Adelaide Oval, Cowan-Dickie appeared to take a knee to the head as he made a low tackle and failed to return to his feet.
Play was held up for several minutes while the Englishman was attended to by medical staff. Eventually, he was put in a next brace and placed onto a stretcher, before being taken off. Lions management wasted little time in replacing him, with Ronan Kelleher sent on while Cowan-Dickie was still being checked over.
Under World Rugby rules, the 32-year-old will now be subjected to an initial HIA check from doctors. He will then be required to go through two further checks before being cleared to play again.
Given the apparent seriousness of the injury, it appears almost certain that Cowan-Dickie will be ruled out of the first Test in Brisbane next Saturday. A simple concussion in professional rugby union must now be followed by a 'graduated return to play' process, with a minimum stand-down period of 12 days.
He had widely been expected to be named in Andy Farrell's squad for the Test series matches. Although Irish hooker Dan Sheehan currently appears in pole position to start, Cowan-Dickie was expected to be next in line and utilised against Australia as an impact player.
On Sky commentary, pundit Dan Biggar said: "It's ahead injury so we hope first and foremost that Luke Cowan-Dickie is ok. But seven days out from the first Test, this is really worrying for Andy Farrell and his coaches."
The injury marred what had been a strong first-half showing from the Lions. In arguably their best 40 minutes of the tour, two tries from winger Duhan van der Merwe and one from scrum half Ben White opened up a comfortable 17-0 lead.
The momentum continued early in the second half as centre Sione Tuipulotu cut over from close range. The clash is the final chance for Farrell to test his players before the opening Test, with the tourists aiming to win a series for the first time since their last visit to Australia in 2013.
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