Concussion: movies vs. reality

Our hero sinks back into the shadows, waiting for the night watchman to make his regular rounds. He doesn’t have to wait long. He swings with the butt of his pistol and renders the guard unconscious with a blow to the head. “Sweet dreams,” he says. “You’re gonna wake up with a wicked headache.”

Stop the video. For decades, good guys and bad guys (and girls, too) have been knocked out with a bop on the head, a sock to the chin or a quick karate chop. The movies’ all time knockout champ has to be super spy James Bond, who usually comes into consciousness bound and gagged for the next cliffhanger. The hapless detective on The Rockford Files was knocked out pretty much every episode of the TV show’s six-season run.   

We asked Dr. Kenneth Podell, a neuropsychologist and co-director of the Houston Methodist Concussion Center: Is it really possible to smack someone in the head and render them unconscious?

The short answer is yes, it is indeed possible, but the complications come after. “If you hit somebody hard enough with an object to cause unconsciousness, you could also be hitting them hard enough to break the skull,” Podell says. “It depends on the weapon … one with a large surface area (like a frying pan) dissipates the shock over a larger area, while a smaller weapon focuses the force and can easily fracture a skull.”

It doesn't take a big blow to result in a concussion that carries many long-term health effects Click To Tweet

Podell has seen many cases of people suffering long-term effects from concussion after receiving a blow much less violent than those usually depicted in movies. A person coming out of an unconscious episode, waking up as if from a nap, does not happen most of the time. “There’s a kernel of truth there but a blow substantial enough to cause unconsciousness is also very, very dangerous,” he says.

Let’s speed up the video a bit and check out this part: two combatants grapple fiercely in hand-to-hand combat, and the battle is at a deadlock. Suddenly, one uses an explosive head butt to stun his opponent and gain the upper hand.

“Again, this has a bit of truth to it as well … the front, top part of the skull is the thickest part and can theoretically be used as a weapon,” Podell explains. “But remember that’s also the other guy’s thick skull, so the butt-er needs to select a weak point on the butt-ee, like the bridge of the nose or the side of the head.”

Podell cautions that any kind of head injury has the potential to be very serious and have long-term complications. Concussion can cause dizziness, shaky balance, confusion, headaches and memory loss that can linger for weeks or even months. If you suspect you or someone you know may have had a concussion, please immediately seek medical care. 

Like many other physicians, Podell regularly sees things in movies that don’t really line up with real life. He tries to check his expertise at the door, he says, and suspends disbelief to enjoy the fantasy on screen.

Denny Angelle

Denny Angelle

Senior Editor at Houston Methodist
Denny Angelle is a senior editor at Houston Methodist. A former journalist, his work has appeared in a number of publications including Boysí Life, the Houston Chronicle, USA Today and Time.
Denny Angelle

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Denny Angelle

Denny Angelle is a senior editor at Houston Methodist. A former journalist, his work has appeared in a number of publications including Boysí Life, the Houston Chronicle, USA Today and Time.