"This is not a test you want to cheat on," said manager Clint Hurdle, who had held off on making out his lineup card until getting medical updates on both Presley and Pedro Alvarez.
Alvarez, after missing two starts with complications of leg cramps, was back in the eventual lineup against the Astros. Presley's place in left field was taken by Drew Sutton, walk-off hero of Tuesday's 8-7 victory.
Presley was jarred making a headlong diving try for Jed Lowrie's first-inning looper, and complained of not feeling well a few innings later. He was removed from the game before the start of the fifth inning.
"It was a whiplash-type scenario. He hit the ground, and his lower torso came up," Hurdle said, describing the incident. "We follow an explicit battery of tests. This is one area in which the player has to interact honestly with the questioning process. It's amazing what kind of a feedback you can get with these tests. They give you a pretty good read on where the player is."
As of an hour before Wednesday's 1:35 p.m. ET first pitch, the Pirates had not decided whether to take advantage of MLB's relatively-new seven-day disabled list for concussion cases.