You could not accuse England of failing to take Mike Brown’s concussion seriously in the wake of the blow the Harlequins star took during England’s victory over Italy on Saturday.

With Brown still not symptom-free he has not been allowed to train this week making him an increasing doubt for the third Six Nations clash against Ireland on March 1.

We have to assume the 29-year-old would not have been fit to face Ireland had that fixture been scheduled for this weekend.

Following George North’s injury in Wales’ defeat to England the previous weekend, head injuries are becoming a major theme of this year’s Six Nations and their prevalence is becoming a worry.

We can hardly be surprised this is the case given it was last week revealed there had been a 59 per cent season-on-season increase in head injuries in English rugby during 2013-14.

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Some of the increase may be down to reporting incidents, but there is no doubt that players are getting more powerful and much of the sheer bulk of the amateur era has been replaced by muscle as full-time fitness regimes have been introduced.

At some point the game needs to change. Head injuries are dangerous and – as the Philip Hughes tragedy in cricket has shown – being an international sportsman does not make you immune from the worst possible scenario.

Wales star Leigh Halfpenny – a poster boy for men’s fitness magazines – already sees fit to wear protection to his head that is only removed when he kicks for goal.

If the traditionalists don’t like the thought of players starting to look like American footballers, there will need to be changes to the game itself – whether it is to do with outlawing certain types of tackle or putting rules in place to stop players from becoming increasingly powerful battering rams.

Introducing protocols for dealing with head injuries is one thing, but it is reaching the point where rugby needs to confront causes rather than symptoms before somebody pays the ultimate price.