Blows to the Head (A medical review of Jack Cross #3)
Jack Cross #3 “Love Will Only Get You Killed, part 3 of 5”
Warren Ellis, writer
Gary Erskine, penciler
In Jack Cross #3, we are treated to a lovely picture of Cross punching an opponent in the head and the damage to the brain beneath the blow. Nice image. Of course, brain injury doesn’t quite happen that way.
The brain is a well-protected organ. It is surrounded by the skull and several tough membranes. In addition, it is floating in a layer of cerebrospinal fluid which acts as a kind of shock absorber. The only way a blow can directly injure the brain is if it cracks the skull and impacts the brain.
However, because the brain is floating in the cerebrospinal fluid, strong blows will cause the brain to move around within the skull cavity. The acceleration and deceleration caused by severe blows can damage the brain leading to concussion, unconsciousness, and even permanent brain damage. The exact reason that these forces injure the brain is unknown, but is thought to occur on the cellular level. Rotational acceleration is even worse, leading to more severe damage.
In extreme cases, a blow can cause enough acceleration for the brain to impact the inside of the skull. This impact can cause direct damage to the brain in addition to the cellular injury mentioned above. Strong punches can also tear blood vessels within the skull and brain, leading to intracranial hematomas which can cause unconsciousness or death.
Think about boxing. The competitors don’t pummel each other’s foreheads trying to injure the brain; instead they strike the jaw in an attempt to land a solid blow that snaps the head back (linear acceleration) or around to the side (rotational acceleration).
I’ll gladly admit that this post has been an oversimplification of the brain injuries caused by brawling, but it’s a good basic primer in how these injuries occur — and it’s not by a direct blow to the brain.
January 4th, 2006 at 9:03 am
I think that you should include some mention of the boxer’s fracture that Jack is getting from punching someone in the head that way.
January 5th, 2006 at 7:34 pm
Also, isn’t it the case that the damage may be on the side *opposite* from where the blow was landed, from the brain’s movement in the skull being stopped by the skull.
January 5th, 2006 at 10:41 pm
Official Comment
Exactly. That’s known as a contre-coup injury, as opposed to a coup injury. A car accident is the perfect example. Say you’re sitting at a red light and someone rear ends you. The impact causes you to lurch forward, and your head smashes into the windshield. The brain moves forward within the skull intially, hitting the inside front of the skull. This is the coup injury. The brain then bounces back within the skull and hits against the inside back of the skull. This is the contre-coup injury.
January 6th, 2006 at 9:35 am
As request for medical information, would you consider doing a post about knockout punches? Hollywood and comics often treat us to fights containing one punch - one knockout blows, but regular viewers of Ultimate Fighting Championship know it can actually be pretty hard to knock somebody out, and that they don’t necessarily stay out for all that long (some do go down for a few minutes, but others just “get rocked” and recover within a second or two and can continue fighting intelligently. Is there a medical difference here?). Seems like you have to hit someone just right, like a flying knee to the head, or a hook knocking the jaw sideways, maybe hitting some sort of nerve or something? to really trigger a knockout. As you can see, I clearly have no clue about how knockouts really happen, what happens in the body, why some blows are more likely to knock an opponent out than others, etc. Or wait, let me search your archives and google first…. Still knockouts in comics and on screen could probably use some polite dissenting, yes?
January 6th, 2006 at 9:58 am
Official Comment
Good idea, Matt, those one-punch knockouts have always bothered me. I’ll do a full post on that whole scenario.
Meanwhile, here’s a short answer to one of your points. Boxers (and other fighters) can take a blow that momentarily disrupts their vestibular system (the brain’s balance system). These are the fighters who get knocked down or stumble, but can shrug it off after a few seconds (as the vestibular system recovers) and return to fighting. It’s different situation than what I described above, and not as dangerous.
January 9th, 2006 at 6:11 pm
So, Doc, can I get you to weigh in on what kind of damage Hal Jordan’s brain has sustained over the years….?
January 10th, 2006 at 12:09 am
Official Comment
One of these days I’ll post about dementia pugilistica, an Alzheimer’s-like condition thought to be brought about by years of punches to the head.
February 10th, 2006 at 1:49 am
My personal experience to a knock out confirms the rotational force.
I was hit under the jaw by a 2 x 6 stud. I had placed it in front of my shoulder and used it to push a large piece of concrete out a window opening as it was being removed from the header of the window opening. This concrete block rolled and made a nice teeter-totter and I rode the other end. Although the distance from the board to the underside of my jaw was only 4 to 6 inches, the force was enough to give me air time of 20 feet and a knock out time of about 5 to 10 minutes.
Last year I receive a nasty whiplash injury, a similar rotational force that put me out or dazed me for up to 1 minute. Now I suffer many cognitive difficulties and a personality change. I’ve read the tearing damage created by the scraping effect in the frontal lobe is worse than the contra coupe or a bang on the head. I recently have been finding articles on the web identifying what’s now called “programmed cell death” as it relates to brain cell tearing.
I haven’t tried it yet, but give a container of Jello a few hard shakes verses dropping it on the floor.
March 18th, 2006 at 9:04 pm
[…] dump at 4:39 am by Raj Finally, bionic muscles How Flickr scaled A medical analysis of a comic book character’s punch. Good to know! Permalink […]
July 8th, 2007 at 2:37 am
I don’t know how true this is, but I had a martial arts instructor describe the “glass chin” method of knocking a person out to be based on their being a never that runs along the lines of the jaw. A sharp blow there disrupts things enough to knock a person out or at least disorient them. It might have just been suggestion, but my knees went weak for a second when he demonstrated by pinching my jaw there. *facepalm* That last sentence reads to me as just shy of something you’d see in a bad romance novel, but I think it says what I meant it to.
May 20th, 2008 at 2:58 pm
Scott, I feel back and hit the back of my head against the wall last night, when I started to sit on the arm of the lazy boy chair and the chair tipped over, and my head went smack against the wall behind me, and bent my neck when it happened. Today I have headaches, I’m very tired, and I have had to take numerous ibuprofen as my back right-side of my head hurts and so does my neck. Should I have maybe went to the doctors with this? I don’t have insurance is why I mainly didn’t. I remember everything about the incident which is good!
Kim
May 20th, 2008 at 2:59 pm
Scott, I meant I fell back in the chair!
Kim
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