Former Welsh international died from dementia caused by repeatedly heading the ball, inquest finds

A former international footballer died from dementia caused by him heading the ball repeatedly during his decades-long playing career, an inquest has found.

Defender Keith Pontin, from Pontyclun, played centre half for Cardiff City between 1976 and 1983 and had more than 200 league appearances as well as being capped twice by Wales.

He was diagnosed with early-onset dementia in 2015 aged 59, and died at the Royal Glamorgan Hospital on August 2 2020 aged 64.

His family, including his wife Janet – who has campaigned for a better understanding of dementia among players – and his two grown-up daughters, have always believed his condition was linked to years of sustaining multiple concussions during matches.

Pontypridd Coroner’s Court heard on Tuesday that a post-mortem examination carried out on Mr Pontin by pathologist Dr Esther Youd found the cause of death to be chronic traumatic encephalopathy (CTE).

While William Stewart, consultant neuropathologist at Glasgow’s Queen Elizabeth University Hospital – who examined Mr Pontin’s brain tissue, said: “The overwhelming pathology was of chronic traumatic encephalopathy.”

CTE is a progressive brain condition believed to be caused by repeated blows to the head and episodes of concussion. The symptoms of CTE affect the functioning of the brain and eventually lead to dementia.

During the hearing, a list of the injuries Mr Pontin suffered throughout his career, compiled by Mrs Pontin, was read to the court – beginning with a concussion during a match against Wrexham FC when he was was playing for Cardiff City aged 18.

Another incident saw him collide with former professional player and now manager Sam Allardyce during a game, causing him to need stitches to his eye.

Other incidents noted injuries including cuts to his face, blows to his head, a broken nose and a back injury.

Assistant coroner David Regan said a number of statements described Mr Pontin as a “gentle giant off the field”, but was a “competitive” footballer with a “combative” style.

Paul Burrows, a former Swansea City player and teammate of Mr Pontin’s at Barry Town during the 1990s, said the role of a defender used to be more physical than in the modern game.

Mr Burrows said: “He was what I would describe as an old-fashioned centre-half. I’m not sure of his height but I’d guess he was around 6ft 2ins and was expected to be dominant in the air and good at heading the ball.

“That central position is a big, strong, tough defender and people looked up to Keith for this attribute.

“There was a time when he came back on the field with his head bandaged up with blood everywhere. Everyone thought that was great at the time, he was a hero sort of thing.

“Now there’s a lot more emphasis on checking out the head injuries. But back then if the player said he was fine, he would go back on the field.”

‘Repetitive head injury’

Another witness, David Cole from Barry Town – where Mr Pontin played before he retired in 1991, said of the game at the time: “It was a ‘men are men’ kind of attitude, if you went in for a ball and got hurt you just got on with it.”

Mr Stewart gave evidence over video link and said he found a pattern of Tau protein in Mr Pontin’s brain consistent with CTE, and that after collecting a history from Mrs Pontin believed it could only have been caused by his playing career.

“What comes through particularly strongly is the behavioural changes which were unlike him in terms of episodes of aggression and challenging behaviour,” he said.

“All of it fits quite strongly with the current understanding of CTE.

“Dementia is a very loose term for a degenerative brain process, it’s an imprecise term. The precise term in this case is CTE. That is the precise term for his dementia.”

He said around 75% of all former footballers and rugby players with dementia have CTE.

And former footballers are three-and-a-half times more likely to develop CTE later on in life, with the risk jumping to a five-fold chance for defenders.

“There is no evidence yet suggesting changes in the modern game have altered the risk,” he added.

Mark Evans, from the Football Association of Wales, was called to give evidence, but said the organisation no longer held records relating to Mr Pontin.

Clubs including Merthyr Town, Barry Town, and Cardiff City said they also did not hold records on Mr Pontin.

A legal representative for Cardiff City attended the inquest and questioned Mr Stewart over his findings, claiming there was not enough evidence to prove Mr Pontin’s career in football had caused CTE.

However, coroner Mr Regan said he found Mr Stewart “extremely persuasive” and concluded: “Keith Pontin died from chronic traumatic encephalopathy caused by repetitive head injury suffered as a professional footballer.”

Mrs Pontin began to cry as the conclusion was read and was comforted by her daughters.

Mr Regan offered the family his condolences and said: “It’s entirely clear that Keith was a loving father and husband who for many years contributed in a positive way to an extremely happy family life.”