Vertonghen challenged for a header in the Ajax penalty area but slammed his face into the back of teammate Toby Alderweireld's head, leaving Vertonghen with blood pouring from a cut on his nose in the 32nd minute. Vertonghen received treatment on the field and went to change his bloodied white jersey to enable a return to action.
The team doctor is required to perform assessments for concussion symptoms, including asking questions to check the player's awareness. Tottenham manager Mauricio Pochettino did not say if Vertonghen was concussed.
"I wasn't involved. It was the doctor's decision," Pochettino said. "I think it's so important things, the rules and the protocol are there and our medical staff follow the protocol." Spanish referee Antonio Mateu Lahoz was pointing at his head as he spoke to Vertonghen, before allowing him to return to action in the 38th minute.
"The decision was the doctor and the referee asked," Pochettino said. "He goes in. In the next action, we need to put him out because he didn't feel well." Vertonghen lasted only 40 seconds before going across to the sideline, leaning over and struggling to stand. Pochettino had to grab Vertonghen to stop him from keeling over before the Belgian was helped down the tunnel by two medical officials.
Taylor Twellman, whose playing career in the United States ultimately ended because of the lingering impact of a concussion, tweeted that "under no circumstances" should Vertonghen have been allowed back on the field after the clash of heads.
That view was shared by Ajax coach Erik ten Hag. "With a head injury it can be dangerous," ten Hag said on beIN Sports. "Take him off. Don't take risks with head injuries." Vertonghen was seen walking through the media interview area after the semifinal first leg, which Tottenham lost 1-0.
"He's OK. He is good. He was walking away," Pochettino said. "He was more relaxed. I hope it is not a big injury or a big issue. ... You know very well you need to keep eyes watching him and analyzing him because it was a big knock. But I hope it is not a big issue."
FIFA has resisted introducing temporary substitutions to facilitate lengthier concussion checks. Three-minute breaks in play are allowed for on-field checks under protocols adopted in 2014.
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