Alex Zanardi is at risk of brain damage as a result of a head-on crash with a truck during a hand cycling race in Italy.

The former F1 driver, who famously lost his legs in a horror American open-wheeler crash in 2001, crossed into the oncoming lane on a downhill bend and sustained serious head injuries.

Corriere della Sera said the race was not officially sanctioned because of the corona shutdowns, which is why the oncoming lanes were not closed to traffic.

Zanardi, 53, underwent neurosurgery and facial surgery and according to the hospital in Siena "was transferred to intensive care with a reserved prognosis".

Critical care Dr Sabino Scolletta told Italian media that the hand cycling Olympic champion, now connected to a ventilator, had arrived at hospital "with practically all the bones in his face broken".

"The neurological picture is what remains serious, the physical conditions remain stable," he said.

"In the next few days we will evaluate him neurologically if the conditions allow. Will he be the champion of before? We hope so and we are all here for that reason."

However, he admitted that brain damage or a deterioration of his condition is a possibility.

"It may get worse, that is possible, but currently he is stable," said Dr Scolletta, adding that Zanardi is also at risk of "damage to his vision".

"When the brain is less inflamed, the maxillofacial partners will have to intervene to also rebuild the facial part, which we have neglected a bit because there was an immediate risk of loss of life," he added.