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“I think a lot of guys would try to play hurt,” Hendrick said. “I applaud Dale for raising his hand and going in there and getting checked out.”

O'Donnell said NASCAR will likely review the Kansas accident and see if series officials should have handled Earnhardt’s care differently.

Other sports have struggled with their handling of concussion, especially football and hockey.

After years of denying any connection between head injuries suffered on the field and later brain injuries, the NFL now has a protocol before players can return if they show symptoms of a concussion. The NFL is also being sued by more than 3,000 former players who claim it didn’t do enough to protect them.

O'Donnell said drivers have to take some responsibility for their health, as well.

“The process of an evaluation for any athlete or driver, it’s not just NASCAR making the call,” O'Donnell said. “It has to be the driver as well letting us know how he’s feeling. We’ll look at Kansas and see what we may be able to do better.”

Nationwide Series driver Eric McClure was held out six weeks this season with lingering effects of a concussion suffered at Talladega. McClure said the concussion he sustained in the May 5 race was the third of his career, and the frequency was one of the main reasons his doctors and NASCAR officials made him sit out for an extended period of time.

Sprint Cup Series points leader Keselowski knows how hard it is for a driver to consider sitting out a race. He broke his ankle in a crash while testing last summer, and although he had a backup driver on standby, he didn’t miss a Cup start.

“It’s your worst fear, to not be in the race,” he said. “Missing the show is terrible.”