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Former MLS player Scott Vermillion diagnosed with first American pro soccer case of CTE

The late Scott Vermillion, a former MLS player, is now the first known case of chronic traumatic encephalopathy (known as CTE) in American professional soccer, according to The New York Times.

Vermillion died at the age of 44 on Dec. 25, 2020, of acute alcohol and prescription drug poisoning, according to his family, but doctors at Boston University discovered in late 2021 that Vermillion also suffered from Stage 2 CTE after examining his brain. That same year, doctors at Boston University also found that former San Francisco 49ers tight end Greg Clark also suffered from CTE before he died of a self-inflicted gunshot wound at the age of 49.

“Soccer is clearly a risk for C.T.E.," Dr. Ann McKee, the director of the C.T.E. Center at Boston University, told the Times. "Not as much as football, but clearly a risk."

Because of the nature of CTE, it is impossible to know if an individual suffers from it until after they are already dead. But symptoms include memory loss, depression and aggressive or impulsive behavior.

CTE has been a major talking point in professional sports, especially the NFL, for awhile now, but this is the first public diagnosis of it at the professional soccer level in the United States. The issue of concussions in soccer has grown more prominent in the last decade as cases and advocates for better protocols have emerged over the years.

Patrick Grange, a 29-year-old amateur soccer player, was the first named person to have CTE in 2014. Former New England Revolution star Taylor Twellman created the THINKTaylor Foundation after his playing career was derailed by a dangerous concussion in 2010. He was one of the 300 athletes who pledged to donate their brains to CTE research. National Soccer Hall of Famer Brandi Chastain also agreed to donate her brain.

"I hope this brings clarity to the Vermillion family to a very tragic experience for all involved," Twellman tweeted Tuesday. "CTE is a real issue and to nobody’s surprise soccer players are at risk. I hope we continue to evolve & change for the better of our game."

Calls for more concussion prevention protocols in soccer

The soccer world hasn't neglected concussion prevention. U.S. Soccer banned headers in games and practices for youth players in 2015 and English football introduced guidelines for heading at all levels of the sport in mid-2021.

The International Football Association Board also approved the trial use of concussion substitutes beginning in January 2021 — meaning that teams would be given an extra substitution if they pulled a player from a match who suffered a concussion or were suspected of suffering one. But rules were never fully used.

In response to the Times' report, the MLS Players Association called for the league to fully adopt those concussion substitution protocols to help prevent more players from suffering Vermillion's fate.

"Despite the health and safety danger to players, FIFA and FAB have clung to outdated substitution rules that do not adequately protect players. We must not sit by and wait for them to do the right thing. MLS should unilaterally adopt a full concussion substitution rule immediately," the MLSPA said in the statment.

"Current substitution rules do not give medical professionals sufficient time to properly diagnose potential concussions without putting a team at a substantial competitive disadvantage. When a player suffers a potential brain injury on the field, he should be immediately removed from the game and fully assessed by a doctor. During this diagnosis, the rules should allow a team to temporarily substitute another player. The rule now being trialed in MLS has loosened these substitution rules somewhat, but it is not enough.

"Our industry should follow the evolving science and make changes to the game to keep players safe. The first step is obvious."

Vermillion appeared in 62 MLS games from 1998-2001. He played for the Kansas City Wizards (1998), Colorado Rapids (1999-2001) and D.C. United (2001) after a three-year career at the University of Virginia. Vermillion, a defenseman, scored three goals in his professional career before a lingering ankle injury forced his retirement in 2001.

Scott Vermillion died in 2020 but was diagnosed with CTE in 2021. (Brian Bahr/ALLSPORT)
Scott Vermillion died in 2020 but was diagnosed with CTE in 2021. (Brian Bahr/ALLSPORT) (Brian Bahr via Getty Images)