Sickening skull fracture in 1994 World Cup clash left USMNT star thinking he was ‘going to die’

Tab Ramos’ skull was fractured during the United States’ peak moment in the first World Cup on American soil.

Ramos had bleeding around his brain, his team was battling Brazil in a scoreless Round of 16 match as halftime approached, and he was afraid that he was going to die on July 4th.

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Elbow vs Brazil showed passion of World Cup

“I actually didn’t even know that (we lost) until somebody told me in the hospital hours later,” Ramos, who recorded 81 caps and eight goals for USMNT, exclusively told talkSPORT.

Thirty-two years after a life-threatening injury, Ramos still keeps a close eye on Mauricio Pochettino’s USA squad and is able to joke about one of the scariest moments in World Cup history, which still creates chills when watching a grainy video on YouTube.

“In reality, I don’t remember anything,” the 59-year-old Ramos said.

“The elbow, it cracked my skull. So I obviously had a serious concussion, went right to the hospital during that game against Brazil.

“I only remember from doing so many interviews and from seeing so much video after, I’ve sort of reconstructed how I feel about the moment.”

Leonardo’s name was mentioned by a TV announcer as USMNT held onto a tense 0-0 stalemate after 42 minutes and 23 seconds inside Stanford Stadium.

“Leonardo has had a lot of activity so far today,” an announcer said.

Ramos recalls locker room aftermath

During a 1994 World Cup that changed the perception of a global sport in the USA and led to the creation of Major League Soccer, Ramos’ football life was suddenly altered.

He collapsed to the ground, violently reacted, and started to lose feeling in his arms and legs.

“Now we’ve got a card pulled,” said an announcer during a slow-motion replay. “This is Tab, Tab Ramos. Oh! The elbow by Leonardo!”

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As bright yellow shirts clashed with red-and-white jerseys around Ramos’ body, a camera zoomed in on a resilient USMNT midfielder whose career evolved from the National High School Player of the Year and CONCACAF Player of the Year to a USMNT assistant coach and MLS head coach.

“In all of this, we forget that Tab is still down on the ground,” an announcer said. “Oh, man. That is an elbow to the side of his face.”

Leonardo — who later apologized and visited Ramos at Stanford University Medical Center — was given a straight red card and ejected from the match for violent conduct.

“The only thing I could think of when I fell down, I thought I was going to die,” Ramos said in 1994. “I just wanted to keep my eyes open, because I thought I had to fight it to come back. I mean that’s how bad it was.”

USA coach wanted Ramos to return to pitch

Ramos still holds on to a memory of what the USA’s locker room was like in the aftermath of an elbow smash seen around the world.

Instead of subbing in a new player for the injured Ramos, USMNT head coach Bora Milutinovic initially hoped that his midfielder could return to what was then the biggest match in USA history.

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“Our head coach decides, ‘I don’t want to make a substitution. I don’t want to take a chance. I want to see if Tab can come back in the second half,’ ” Ramos told talkSPORT.

“I’m laying on the whatever it’s called in the locker room there. I’m laying there with the doctors on top of me and Bora coming over to me and saying, ‘Can you play the second half?’ 

“And I can’t even answer. And the doctor’s going, ‘No, we’re going right to the hospital from here.’ I do remember that. That is the only thing I remember.  … And then the doctor’s telling him, ‘No, he’s out.’

Brazil defeated USMNT 1-0 with a 72nd-minute goal, then became world champions by topping Italy 3-2 on penalties in the Final.

Ramos underwent CAT scans while planning to return to Real Betis, then eventually became the first player to sign with MLS and spent seven seasons with the New York/New Jersey MetroStars (Red Bull New York).

1994 USA team reached Round of 16 and almost won

“The next thing I remember is Leonardo visiting me in the hospital later that night and me finding out that we lost the game,” said Ramos, who was born in Uruguay and was one of only three USA players to appear in the 1990, ’94 and ’98 World Cups.

“Difficult moment. At the time, I think Leonardo was playing in Spain, as was I. He was a super player, classy — not known for this kind of thing. 

“So for me at that moment, I knew he lost his head, but he wasn’t that kind of player. So I forgave him right away and unfortunately we had to move on.”

youtube@Sipotemundial

youtube@Sipotemundial

Thirty-two years later, Ramos is a member of the National Soccer Hall of Fame and currently the CEO/Head of Soccer at the US National Soccer School.

There would be no 2026 World Cup without a ’94 Cup that displayed the beautiful game to the USA.

Ramos keeps tabs on Poch and USMNT in 2026 Cup

Ramos now wants to see how far Pochettino can lead USMNT with Spain, France, Argentina, England and Brazil all aiming for the same shining golden trophy.

“I’m very happy for the American players that will have hopefully the opportunity to represent their country this year at home,” Ramos said.

“The sport of soccer, football, became the focus of everything that was going on (in 1994). I can only imagine what this summer is going to be like.

“For us as players in 1994, we were on every show, Good Morning America. We became current and for a little while, that was fun. And I think what’s going to happen this summer will be unprecedented in this country, in terms of the attention that football, soccer, will get for the first time.”

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