The issue is that the entire chain of clauses you are looking at it all dependent on "After attacking with Kozil". The lack of a comma makes it clearer that it's all one dependent condition that triggers in that time frame. I guess it's clear either way but it really starts to feel like a run-on.
If I were going to adjust it, I'd back out to the originating clause and go with:
After Kozil attacks a small or medium figure, if Kozil rolled at least 1 skull and is still adjacent to that figure,
This packages it in a way that avoids the double "and" while still making all the conditions intuitively point to the timing window.