Chronic traumatic encephalopathy (CTE) is a severely dangerous brain condition that is on the rise amongst athletes in contact sports.

When research in brain injury first started back in the 1920s, the condition was known as dementia pugilistica, “fistfighter’s dementia," “boxer’s madness” or “punch drunk syndrome,” but the condition has become an ongoing issue in a variety of sports. 

American soccer player Scott Vermillion, who passed away in December 2020, was diagnosed with CTE this week. Vermillion became the first MLS player to be officially diagnosed -- a result that shows the severe dangers athletes incur from playing the world's most popular sport.

Here’s everything you need to know about CTE and its impact on soccer players:

What is CTE exactly?

Chronic traumatic encephalopathy (CTE) is a brain condition caused by continuous head trauma and repeated concussions.

The disease is typically found in athletes involved in contact or striking sports such as boxing, American football, professional wrestling, ice hockey, kickboxing, mixed martial arts, Muay Thai, ruby and soccer.

Other risk factors include being in the military (exposed to combat), prior domestic violence and repeated blows to the head, 

The condition can lead to behavioral problems, mood altercations and difficulty with thinking. If the disease continues to worsen, dementia can develop over time.

The exact cause of CTE is not fully understood, and only supportive treatments are currently available.

While research is focused on finding a reliable technique to diagnose the illness, studies have proven ways to keep athletes safe.

A study conducted by Purdue University found that keeping a soccer ball’s pressure on the lower end of ranges could reduce potential head injury.

How do doctors diagnose CTE?

CTE can only be diagnosed after death through a brain tissue analysis. 

Experts in brain disease take samples of brain tissue and utilize special chemicals that detect abnormal tau protein.

If tau is found, those parts of the brain are systematically inspected in search of patterns consistent with CTE.

Was Scott Vermillion the first soccer player to have CTE?

Former Sporting Kansas City defender Scott Vermillion is the first MLS player to be diagnosed with CTE. 

The late soccer star's diagnosis was confirmed on Tuesday by researchers at the Boston University CTE Center.

Vermillion died of an accidental drug overdose in December 2020 at the age of 44.

“Mr. Vermillion has shown us that soccer players are at risk for CTE,” said Dr. Ann McKee, director of the BU CTE Center. “We need to make every effort to identify players who are suffering and provide them compassionate care and appropriate medical support.”

Why are soccer players speaking out more about CTE?

Scott Vermillion’s family is speaking out and trying to raise awareness. His diagnosis, which came two years after his death, is important to educate the public to raise awareness.

While blows to the head are common, CTE is a progressive degenerative condition that causes severe damage to the brain. Because soccer players are constantly striking balls with their heads during play, they are prone to the disease. 

Scott's father, Dave Vermillion, told Good Morning America that soccer players and coaches don’t often discuss CTE. 

"You heard about it, but around soccer there was no talk of the CTE. There was nothing -- so we had no idea," Dave Vermillion said. "We actually were able to find out what was going on and then the guilt set in because we would all handle it differently if we knew it was CTE."

“If we can help anybody -- one person, two, however many people,” he added. “Then to us, that makes our tragedy something worth the loss of our son and dad."

Briana Scurry, the former starting goalkeeper for the United States women's national soccer team, revealed that brain injuries are difficult to discuss out loud because there can be shame, fear and confusion linked to sharing. Brandi Chastain, Scurry’s former teammate, pledged to donate her brain after she dies to allow scientists to conduct concussion-related brain disease studies.

She also says that women, in particular, may hold back to avoid being seen as weak, vulnerable or “hysterical,” terms that have been used to describe women. 

Because most of the research around CTE and similar conditions has focused on football, not much is known about how brain injuries might impact girls and women differently.

The disparity in research triggered Boston University CTE Center to conduct a study that looks at the consequences of repetitive impact on former professional female soccer players.

"The goal is for us to really be able to understand the long-term consequence of getting your head hit over and over again through high-level soccer in women," said Dr. Robert Stern, the study's lead investigator.