Effects of Blows

Blows Front High Section (above shoulders)

Blow to Top of Head

• Blow to the coronal suture, the line of juncture of the frontal bone and the parietal bones, may cause death due to severe trauma to the cerebrum and disruptive stimulation of cranial nerves.
• Blow to the frontal fontanel, the region between the forehead and the coronal suture that is exposed and seen to pulsate in a newborn infant, may cause death due to concussion and trauma to cranial nerves.

Blow to Forehead

• If the head is moving toward the blow, the brain membrane (dura) may be torn causing a concussion. Also, if one is knocked unconscious and falls, the relaxed head may hit the ground causing a concussion,
• Blow may snap the head back, whiplash, which may chip the spional process and cause great pain.
• Blow to the offrontal sinus may cause one to two black eyes or may cause a fracture that may cause bleeding from nose and may push bone fragments into the brain.

Blow to Temple

• A fracture of the temporal region of the skull may result in middle meningeal hemorrhage. The artery is located in a grove in the skull and may be easily pinched during a skull fracture. If the artery is cut, there may be massive hemorrhage and quick death. A small leak may cause a extradural hematoma with delayed death.
• If the blow is one inch below the temple, a fracture of the zygomatic process may occur causing painful operation of the mouth. A blow to the suture of zygomatic (cheekbone) and frontal bone may cause loss of consciousness due to trauma to cranial nerves or a loss of sensory and motor functions.
• Blow to temporal region may also rupture an eardrum.

Blow to Ears

• Blow may cause a concussion.
• If the eardrum ruptures, the rushing air may cause the auditory canal and estachian tubes to swell causing great pain. There may also be ear, nose, and mouth bleeding.
• Blow may break or dislocate the jaw hinge.

Blow to Eyes

• Blow may cause loss of consciousness due to severe trauma to cerebrum resulting in disruptive stimulation of cranial nerves and loss of sensory and motor functions.
• Blow to the upper and lower parts of eye socket, the circumsornital region, may cause "black eyes." Loss of consciousness may result from cerebral trauma and resulting loss of nervous control.
• The eye bulb may be ruptured causing blindness.
• If the eyeball is even touched excessive watering may cause temporary blindness.
• A cut and bleeding eyelid may cause temporary blindness.

Blow to Bridge of Nose

• Blow may cause fracture and/or dislocation of nasal bone and septum which may cause massive hemorrhage and temporary blindness.
• If person is knocked unconscious, choking may occur from blood in the windpipe.
• Blow may fracture the orbital socket causing cerebrospinal fluid to leak from around the brain, The leakage may seem like normal drainage at first. Sense of smell may be dulled.
• Blow to the glabella, area at the base of the nose between the eyes, may result in loss of consciousness due to severe trauma to the cerebrum that may disrupt stimulation of cranial nerves and cause a loss of sensory and motor functions.

Blow Under Nose

• Blow to upper lip just under the nose, philtrum, may cause excessive eye watering.
• Blow may split the lip or chip or knock out teeth. If teeth get into windpipe, they may cause suffocation.
• Blow may fracture the upper jaw on one or both sides causing great pain.
• Blow may cause concussion or shock.
• Blow to the juncture of left and right upper jawbones just below the nose, the intermaxillary suture, may result in loss of consciousness due to trauma to cranial nerves and loss of sensory and motor functions.

Blow to Jaw

• Blow to the center of the jaw, one-half inch below lower lip, may result in loss of consciousness due to trauma to cranial nerves and loss of sensory and motor functions.
• Blow to the base of the mandible, the lower ridge of lower jaw, or to the articulation below and in front of the ears, may result in a fracture or dislocation that may cause loss of consciousness due to concussion and loss of nervous coordination.
• Blow to the base of the mandible may cause a fracture of the styloid process, a sharp spine that projects downward and forward from the inferior surface of the temporal bone just in front of the stylomastoid foramen and that is derived from cartilage of the second visceral arch. This a fragile bone but it is well protected and difficult to break. However, a powerful punch to the side of the face may break it causing swelling in the throat which may then lead to asphyxiation in few minutes.
• If face is stuck on the cheekbone, zygoma, it may fracture or dislocate sending bone fragments into the maxillary sinus that may cause blood to fill the throat. Blow may also cause a concussion.
• If the facial nerve is injured, it may result in paralysis on one side of the face.
• Fracture of the lower jaw may tear tongue ligaments causing it to spasm. If person is unconscious, the tongue may be swallowed.

Miscellaneous Unexplained Head Injuries

People have hit their head or been struck on the head and died, even though there was little actual trauma to the head or brain. These cases have been blamed on the "transmission of a concussive force through the reticular activating system."

Trauma to Carotid Artery

Located in the side of the neck, the carotid artery provides blood to the head. Pressure on the carotid sinus, an especially sensitive area where the artery divides into two branches, may damage the blood vessel walls, leading to stroke followed by partial paralysis, other neurological problems, or possibility death. The precipitating event may be surprisingly trivial; a knife hand strike has been known cause the trauma, but so has the strain of blowing too hard on a French horn.

Blow to Throat

• Blow may strike the internal jugular vein. The jugular vein pulsates during respiration. It is full and hard during expiration and collapses to a limp, soft ribbon during inspiration. If it is struck during expiration when it is full of blood, it could be crushed against the cervical vertebra, rupture, and cause a quick death. If the vein is bruised, it may swell causing loss of consciousness.
• Blow may strike the internal carotid vein. A contusion may cause vessel wall spasm and restrict blood flow. Blow may cause a blood clot that may move to the brain and cause cerebral thrombosis and death.
• The vertebral artery runs through the spinious vertebral process, so it can be damaged by a chip or a fracture of the process caused by a heavy blow.
• The vagus nerve controls heart contraction and lung contraction. From the brain, it branches out to one nerve on each side of the neck. Striking one side may not be fatal but it could cause spasms of the lungs and heart, which could cause shortness of breath and irregular heart palpitations.
• Blow to the phrenic nerve that runs from the fourth cervical vertebra down into the chest, the thorax, to merge with the diaphragm may cause it the diaphragm to spasm and cause a feeling of getting the "wind knocked out" of you.
• The laryngeal nerve, a branch of the vagus nerve, goes to the vocal cords, larynx, and epiglottis. It closes the trachea so no foreign objects can get into the windpipe. If injured, it mat shut off air and cause suffocation.
• The hypoglossal nerve controls the tongue. If it is injured it may cause loss on control of the tongue which may cause it to be swallowed leading to suffocation.
• The carotid sheath encloses the jugular and carotid veins and the vagus nerve. If blood builds up in the sheath, it could cause a hemotoma that grows with each heartbeat. A large swelling on the neck could result with pressure on the trachea cutting off air.
• Blow may chip or fracture the spinous process. This is dangerous not only because of the fracture, but because of damage to everything else in the spinous process. Blow may cause whiplash or spinal cord shock that may injure the spinal cord without breaking it.
• A frontal blow to the throat (Adams's apple) may fracture the thyroid or cricoid cartilage or damage the laryngenial nerves that may lead to suffocation.
• The sternocleidomastoid muscle leads down the side of the neck. A blow may cause of loss of consciousness due to trauma to the carotid artery and the pneumogastric nerve that may lead to shock and to loss of sensory and motor functions.
• Blow to the supraclavicular fossa, the front portion of the throat on either side, just above the collar bone at the origin of the lateral head of the sternocleidomastoid muscle, may cause trauma to the artery located below the collar bone and to the sublingual nerve, which may lead to shock and loss of motor functions.

Blow to Collarbone

• Fracture of the collarbone may disable the arm on that side and cause the shoulder to drop.
• Fracture of the clavicle may injure the branchial nerve plexus that may cause paralysis to all or part of the affected arm.
• The subclavian artery may be cut or pinched by muscles that could cause blood to be shut off. If blood is shut off too long, gangrene may occur.
• Heavy blow may drive a broken bone into a lung and puncture the plurae (the thin sac membrane covering the lung) which may collapse the lung and lead to air starvation, dizziness, coma, and death.