In movies and TV shows someone will occasionally “knock out” by hitting them over the head with something. The victim gets hit and then just drops, as if fainting.
Is this actually possible or realistic or is this just TV and movie BS?
It is a common movie and TV trope that is almost total nonsense. If you hit someone on the head hard enough to knock therm unconscious, you have almost certainly given them a concussion and potential cerebral hemorrhage, and while you often see characters estimating that they should be unconscious for some specific period of time, in reality they may come to almost immediately or be in an indefinite coma with no real way to tell when (or if) they will regain consciousness.
I have been knocked “unconscious” twice by a head injury and in both cases returned to a state of semi-consciousness within seconds, although in one case I was uncoordinated and had difficulty interpreting language for several minutes.
Stranger
It you peruse fight videos on YouTube, or elsewhere, you’ll see real-life knockouts happen. It’s not quite the Hollywood look, but it does happen.
Most “knockout” punches in fights don’t really knock the opponent unconscious but stun them enough that they become disoriented and lose their balance. You can cause someone to become briefly unconscious by hitting the side of the neck impacting the carotid sinus which disrupts the blood pressure regulation (speculative, but unlike all of the other Dim Mak stuff I’ve actually seen it happen).
Stranger
A blow to the head is going to impart any range of motion to the skull. The brain quietly sitting in there will similarly be smooshed by the moving skull in a wide rage of possible motions. The classic knockout punch to the jaw seeks to rotate the skull and torque the brain inside. This isn’t going to be a good thing.
Anything from a short compression of parts of the brain maybe causing it to lose function for a moment, right though to tearing of larger blood vessels and swiftly fatal outcomes. In the middle there is going to be damage to minor blood vessels with any range of long term damage. Actual shearing damage to brain tissue is also possible. A colleague of mine when I was in graduate school was hit by a car whilst crossing the road. The trauma sheared off the entire olfactory connection to his brain and he permanently lost any sense of smell.
My father (a radiologist) was adamantly opposed to boxing as a sport. His answer to critics was to suggest mandatory CT scans of the heads of competitors. Minimally after a knockout, but preferably if anyone took a blow to the head. He was confident that a scan would invariably demonstrate bleeding. Such demonstrated damage was, he felt, almost guaranteed to focus the minds of competitors and organisations on the question.
Lots of sports can involve unintended head strikes. Most football codes or a start. You see the occasional knockout. The question of long term damage is something that is downplayed, but is getting more prominent. But it is hard to remove the risk. Sailors learn very early to respect the boom. An unintended/uncontrolled gybe can sweep the boom across the boat with devastating consequences. Ironically one day sailing on my father’s boat just this happened and the boom knocked my father out. He was standing in the companionway just as the boom swung and he went down just like the movies. Apart from a nasty gash and a few minutes disorientation he was OK. But I was seriously worried. There are far worse outcomes.
Knocking someone out is a serious injury. Movies make it seem like its not a big deal…person is unconscious for 10 minutes and they wake up and are fine.
That’s not the case. Knocking someone out is brain trauma. Not to be taken lightly.
Below is a video of some random Joe who got involved in a fight, punched a guy once, and killed the person. Not cuz he was a badass. Not cuz he was huge and powerful. It’s just that easy.
One of my favorite pop-science / video game channels on just HOW deadly “Knocking out” ends up if viewed via reality.
I did that once. Stood up in the wrong place and whacked my head on the corner of the cabinet above my cubicle’s desk, hard enough to leave a dent in my skull.
Twice for me too. Very similar.
We’ve all seen the cartoon characters that get bonked and then had stars spinning around their head. That’s exactly what it felt like.
Once was from a fall. Another was a very nasty head injury from a motorcycle accident. I was wearing a helmet but the rear fender managed to slide between the helmet and my scull. I was basically scalped.
There are videos out there that last show a person knocked out for a period of 15 minutes or more, then recovering with no permanent damage?
There is also a common trope in television and movies of a character being hit on the back of the head with the butt of a rifle causing them to go comatose for some period of time sufficient to move them to another location (never mind how difficult it is to pick up and move an unconscious body) and then reawaken rubbing the back of their head and making witty comments. In fact, blunt force trauma to the back of the head sufficient to result in unconsciousness is likely to cause at least temporary damage to the occipital lobe (interfering with vision processing), injury to the cerebellum (which provides motor control, attentional focus, speech articulation), and possible damage to the brainstem and cervical (upper) spine, as well as the rebound potentially impacting the frontal lobe and damaging the prefrontal cortex (executive functions such as speech formation, ‘working’ memory, temporal awareness, critical decision making and planning, et cetera).
Although all blunt force head strikes are of concern, hits to the back of the head and upper spine are particularly concerning because of the significant likelihood of damage resulting in impairment, and often result in ataxia, loss of sensory control and proprioception, post-traumatic amnesia, and numerous other signs and symptoms which can last for an extended period of time and result in lifelong impairment. In initial head-to-toes (H2T) injury assessment this is why we look for any sign of injury to the skull and unprotected base such as contusions, swelling, blood, crepitus of the skull, bruising behind the ears (Battle’s sign), and then perform a basic neurological trauma assessment with the Alert and Oriented Mental Status Exam (AOx) by checking pupil response, memory (who, where, when, what happened), peripheral sensory and motor functions, stability of vitals, et cetera even if the subject reports no injury and does not recall falling or being struck. For anyone who has fallen and not found already upright or ambulatory, it is recommended to preventatively immobilize the patient’s head with a soft brace (towel around the head and neck) and perform a focused spinal assessment, and if they have been unconscious, are less than AOx4, or show any signs of head or spinal injury or impairment, maintain the immobilization to the extent possible until EMS arrives and they can be transferred to a higher standard of care with a more comprehensive neurological examination can be performed by a physician.
Needless to say, blunt force head wounds are potentially very serious injuries, and causing one just to knock out a guard or whatever is really not the simple and easily recoverable condition that is portrayed in entertainment media. Like the ‘flesh wound’ to the shoulder that somehow doesn’t do permanent damage to that delicate complex of tendons, ligaments, muscles blood vessels, and nerves, it is a creation of screenwriters, the vast majority of whom have never been knocked unconscious or shot.
Stranger
I too was knocked out in my youth by falling backwards and hit the ground. It was in a doctor’s office and he used smelling salts to jar me awake. I’m OK (twitch, twitch).
For whatever reason, I’m hooked into YouTube’s street fight algorithm. So yes I’ve seen hundreds of fights that ended in essentially one-punch knock-outs. It definitely happens. How long they stay knocked out or if they sustain brain damage is unknown. But some of them remained unconscious until the end of the video.
Also, UFC. There are knockouts where the victim stays unconscious for a few minutes and then recovers. I’ve seen these same fighters return to fight again.
I trained in martial arts for a while and once while sparring I spun and my opponent advanced into an elbow. Knocked him out cold for about 3 or 4 minutes. He recovered with no brain damage.
And you know this because…?
As he was in my class, I talked to him afterwards. As a precaution, he went to the doctor and they cleared him.
There a boxer who fought under the name Butterbean who was a knockout artist in every sense. But his highlights are KO after KO, against qualified and determined opponents, with nothing more than nice padded gloves.
Yep, and of course Mike Tyson.
I once attended a delightful talk on head injury by a noted neuropsychologist. She said, “If you must receive a blow to the head, try to take it on the front. We evolved in the trees and are built to better withstand hitting the thick, forward-facing part of the skull.”
The always safe and effective knockout blow is crap. I have had two concussions.
I was attempting to do a minor stunt on a porch swing. It did not work out well. I found myself confused and lying on the cement porch floor. Then, I experienced by far the greatest physical pain I have ever known. Then, a wave of nausea. I managed not to vomit. I insisted that I was fine and just needed to lie there for a while. My friends quite correctly insisted that I go to the ER. I did not lose consciousness. There was intermittent flashing on the right side of my field of vision. I coud form complete sentences only with effort. I was too dizzy to even sit up for any length of time for two days.
The second concussion was not my fault. I was walking back from a local drugstore with junkfood. A driver who was busy on their phone hit me. I learned that only later. I have vague memories of waking up on the asphalt wanting a Heath bar. I lost consciousness again. I woke up laying on my back surrounded by people. I asked “What happened to me?” Somebody answered “You got hit by a car.” I muttered “Yeah. That would explain it.”
I regained full consciousness and was aware that I was in an ambulance and that a crew of EMT’s were running tests on me. I passed the physical tests. They asked me how old I was. I admitted that I could not remember. I had to think what year I was born and then subtract that from the current year. Oddly, I didn’t have any dizziness, nausea, or vision problems this time. Nor did my head hurt all that much. The entire rest of my body hurt and my mobility was restricted for a week or two.
OTTOMH
I have a vague memory of seeing on the news (at least 35 years ago) that a professional boxer (I think it was Boom Boom Mancini) had accidentally killed an opponent. This was with trained medical personell standing by specifically to deal with head injuries.
Doctors know a lot more now, fortunately.