The tests were a precautionary measure, the team emphasized, but the level of concern throughout the Tigers clubhouse was serious.
"I'm actually pretty concerned," starting pitcher Max Scherzer said. "You see how many times he's getting just worn out in the face mask. You just wonder how many times those add up. So you really wish him the best."
Avila took a foul tip behind the plate in the fourth inning and received a visit from manager Jim Leyland and Tigers head athletic trainer Kevin Rand after home-plate umpire Ron Kulpa noticed bleeding around his ear. An initial exam, Leyland said, suggested the bleeding was outside the ear, rather than inside.
"One of the questions I asked him was, 'Is your vision and everything OK? Are you light-headed?' And he was fine," Leyland said. "But when he came into the dugout, evidently he went down underneath. And when Kevin was checking him out, he told him he was nauseous and light-headed.
"When you hear that kind of information, you take guys out. You don't mess around with that."
Brayan Pena, who caught all 14 innings of Wednesday night's marathon victory, replaced Avila behind the plate for the bottom of the fifth.
It's the second time in as many years Avila has left a game in Cleveland with concussion symptoms. The Tigers were here last September when Avila collided with first baseman Prince Fielder in front of the Tigers dugout chasing a pop fly. Avila had similar symptoms and missed four games.
As Scherzer noted, Avila is known for taking an abundance of foul tips off of his head and body. Leyland has said more than once that he takes more than any catcher he has seen.
"This isn't the first time I've been concerned about it," Leyland said, "but normally … I mean, when I was out there talking to him, he said he was fine and vision was good. But evidently he got nausea and that. I don't want to predict anything, but that's usually not a good sign."