The danger of one punch: resultant head trauma

24th Mar 2014

Sydney neurosurgeon Dr Richard Parkinson explains what kind of damage a single punch to the head can do.

Sadly, it seems the news has too many stories of young men ending up in hospital—or dead—after being punched in the head while out on the town. There was a lot of publicity about this issue over the past year or so, after a Sydney teenager, Thomas Kelly, died after being hit for no reason while walking down the street in Kings Cross after a night out. I’d like to say things have changed, but tragically, I believe I am seeing a greater number of these cases than ever before. People being king-hit, people being hit from behind, people being assaulted for no particular reason, and suffering resultant head trauma… there seems to be a far lesser threshold for people to be violent than there used to be. It’s a matter of great concern, especially in the area around St Vincent’s Hospital, which is about a kilometer away from where Thomas Kelly was assaulted.

The reality is that hospital head trauma / injury units are full of patients who have been king hit and are vegetative, or requiring nursing home care, simply because of one hit.

Perhaps because many people are familiar with the word concussion, they don’t realise exactly what it means. A concussion is an immediate traumatic paralysis of the nervous function of the brain. It can involve a whole lot of effects that happen hours, or sometimes days, afterwards, and it’s these after-effects that can have significant, long-term impacts.

If you sustain a concussion, particularly if you sustain a severe concussion, then you’re probably going to suffer permanent brain damage as a result of it. If you’re knocked out from a severe knock to the head, you’re probably going to sustain some permanent damage to your brain. It’s that simple.

I don’t know if young men understand that it’s nothing you’re going to walk away from. In that situation, the type of injury, as everybody has seen, can easily result in death in a worst-case scenario. It can also result in swelling of the brain, and other instances of terrible head trauma happening to you.

I’m not from Sydney originally, so I don’t know if this has always been the case in this city – that young men go out, get drunk and get into fights. But I do get the impression that there’s a bit more of an era of the angry young man at the moment. I don’t know why. I think that’s a social question rather than a neurosurgical one, but certainly in the media it seems to show some concern about it.

One of the factors may be the use of amphetamine drugs. We know that these drugs can change the structure and function of the brain, and those changes can be long-lasting, changing the way people behave. Certainly, the use of amphetamine drugs seems to make people a lot angrier and more prone to violence. We certainly see that here at St Vincent’s among neurosurgeons and other doctors.


About Dr Richard Parkinson

Dr Richard Parkinson is a Fellowship trained neurointerventional neurosurgeon and minimally invasive spine surgeon based in Sydney. He has been performing minimally invasive and complex spinal surgery for 18+ years and has built his reputation on his conservative approach to surgery. He operates at Sydney’s leading private hospitals and has performed surgery on a very significant volume of patients requiring both straight-forward and complex spine surgery. Read his full biography here.