Head injuries in Anime Part 1- Skull Fracture
Shounen anime and the overlapping category of martial arts anime are often defined by the powers the main characters possess and the battles they go through during the course of the story. This is the same whether we are talking about classics like Dragon Ball Z and Hajime no Ippo, or more modern shows like One Piece and Hunter X Hunter. Now I love a good fight scene as much as the next guy, and there are many, many issues I could take with any number of combat oriented anime, but there is one issue that almost all of them share, and that is head injuries. You rarely if ever see an anime character have any sort of lasting effect from a blow to the head, regardless of how bad the impact was. I do realize this isn’t much of a surprise, seeing as most of these shows wouldn’t last very long if the main characters were sidelined or crippled with serious permanent injuries like a skull fracture. However, it does beg the question of what should or shouldn’t be happening to these characters over the long haul.
The Brain and Its Protections
The brain is the center of conscious thought, and controls/regulates all of the functions of the body in some way, shape, or form. It amounts to 2% of the body’s weight and accounts for up to 20% of all the energy used by the body. Needless to say, the brain is very important, and needs to be protected in order for the body to function correctly. The first line of defense against injury is the skull, which is a series of interlocking bones that acts like a natural helmet, protecting the brain from impact damage.
The skull can be further divided into two parts: the neurocranium and the facial skeleton. The neurocranium is the part of the skull that protects the brain and is made up of 8 interlocking bones that form the cranial cavity which holds the brain.
The facial skeleton also consists of 8 bones, and it is mainly involved in eating, breathing, holding the eyes in place, and of course shaping the face. While it is not involved in protecting the brain, injuries to the skull and brain can involve the facial skeleton.
As we know from a previous post, bone is surprisingly strong, but does have its limits, and bones can and will break, including the bones of your skull. Thankfully, though, it does take a large amount of force to fracture or break your skull. However, just as there is more than one way to cook an egg, there is more than one way to damage your brain beyond trying to turn it into paste.
If you have ever done that staple of elementary and middle school science class projects, the egg drop, then you know that having something very fragile in directly contact with the hard-outer shell trying to protect it is a bad idea. You need to have a layer of padding between the hard-outer shell and the fragile egg it is trying to protect.
Our brains are much the same way and they are not in direct contact with our skull. There is a layer of tissue and fluid between the brain and the bones of our skull. The reason for this is that even if your skull doesn’t break when your little brother hits you on the head with a frying pan, your brain could still be injured by the force of the impact. The meninges (tissue layers) and the cerebrospinal fluid are protective layers that surround the brain that help to absorb the force of any impacts on your head. This is why I don’t end up with a concussion every time my students drive me to the point of slamming my head against the wall.
The first of three layers is called the dura mater and connects to the inside of the skull. It is the thickest of the three layers and contains some blood vessels and nerves.
The next layer is called the arachnoid layer and it is a very loose layer that does not contain any blood vessels or nerves. Just below the arachnoid layer there is a gap in the tissue layers called the subarachnoid space. This open area is filled with cerebrospinal fluid, which is a special liquid that nourishes and supports the brain. Think of it like an air bag for the brain that absorbs the force of an impact to the head.
The final layer is called the Pia mater and it is a thin layer of tissue that runs directly over the brain.
Oh, and of course the most important part of protecting your brain is to not get hit in the head in the first place.
Bump on the Head
There are a variety of head injuries, but we are going to start with one that happens to be an anime classic, the bump on the head.
The reason doesn’t really matter, but it is usually the result of one or more males annoying a female to the point of violence. What does matter is the result, since it is clear the blow did enough damage to cause blood vessels to break, which caused the bumps or bruises to form. One last thing to mention is that a bruise on the head looks more like the image below than what we commonly see in anime.
As you can see it is more of a small bump, and less of a large spherical protrusion from the skull. In fact bumps on the head in anime more closely resemble a cyst than a bruise, and cysts would form over a long period of time, unlike bruises, and would not contain blood.
Now I know what some of you might be thinking: a little bump on the head that just causes a bruise is not all that dangerous. Well, you would be right to a degree. The problem is that sometimes a bruise on the skull is just a bruise, and sometimes it’s a bit more than that and can indicate a skull fracture.
While a skull fracture is a very serious injury, and it usually means there is damage to the brain, you can have fractures without brain damage, I mean what would be the point of the skull if it didn’t protect the brain that it encloses. There are also a variety of different types of fractures listed below.
Linear fracture- the least dangerous
Depressed fracture- bone fragments are pressed in towards the brain
Diastatic fracture- usually occurs in children
Basilar fracture- very rare
Growing fracture- occurs in children under 3 years old
Cranial burst fracture- occurs in children under 1 year old
Compound fracture- bone fracture and the skin is cut
Compound elevated fracture- usually caused by a weapon
It would take far to long to discuss all of the different varieties of skull fractures, so I’m only going to be focusing on the ones that are likely to have happened in specific anime.
Getting Your Face Punched in, aka Depressed Fracture
The classic skull fracture in anime (if there is one) is the almost ubiquitous getting your face punched in. While it has happened in many an anime, I am going to focus on Naruto, specifically one punch from the Valley of the End fight, where an enraged Naruto quite literally punches Sasuke’s face in.
Since this is anime, Sasuke is thrown back and stunned for a bit, with no bleeding or lasting damage. However, in the real world the result would be quite different, as was the case on Dec. 9, 1977, when Kermit Washington punched Rudy Tomjanovich, during an NBA game where they were on opposing sides.
The punch shattered Rudy’s jaw and facial bones, dislocated his skull, and cerebrospinal fluid, which never leaves the nervous system, was leaking into his mouth. The blow had the same force as being thrown from a car at 50 miles an hour. All in all, Rudy was lucky to survive after being rushed to the hospital, and it was five months until he was able to return to the basketball court.
Warning: Extra Science Content
For those of you who are medically inclined, you have probably already said wait a minute, you can’t have a dislocated skull. And that is correct, the skull can’t be dislocated, but what the term is actually referring to is a dislocation of the atlanto-occipital joint, which is where the skull is attached to the spinal column.
A dislocation of this joint, aka a dislocated skull, is fatal 70% of the time and the remaining 30% need immediate hospitalization, where an additional 15% perish, so only around 15% survive long term after receiving such an injury, but it does happen.
Extra Science Content Over
First off, if a professional basketball player can throw a punch hard enough to cave a man’s face in, then I have no problem believing that an enraged Naruto, who has been trained as a Ninja and knows how to throw a punch, could as well. As for Sasuke surviving, that is believable given that Rudy survived such a grievous injury. The problem, of course, is Sasuke standing up a few seconds later and continuing the fight. I will admit that Sasuke was also trained as a ninja and probably used to being hurt and working through pain, but we’re not talking about some bruising or pulled muscles, but multiple broken bones that were driven into the brain.
Use of the Baka Bat
Another very common anime cliché is the angry girl/woman hitting her friend/love interest with a large blunt object when said friend/love interest angers her. Some notable examples of this include Akane Tendo from Ranma ½ and Winry Rockbell from Full Metal Alchemist.
Edward Elric has a tendency to do things that Winry is less than pleased about (mainly risking his life), and she punishes him by smacking him around with her wrench. Now unlike most other cases, Edward does show some degree of injury from the blows, and he typically remains injured for a short period of time. That being said, the injuries he receives from Winry are never treated as being extremely serious, and yet we can clearly see that he is unconscious and bleeding. I don’t know about you, but unconscious and bleeding after being smacked on the head with a wrench is clearly a serious injury and not something to be ignored.
If we go with the idea that Winry hit Edward hard enough to fracture his skull, there are several clues as to the type of skull fracture Edward now has thanks to Winry.
1- Edward’s bleeding head indicates that the skin was cut as a result of the impact. A compound fracture occurs when the bone is broken, and the skin is cut.
2- The use of a weapon
Compound fractures are not the most common type of skull fracture; they are often caused by assault, and assault using a weapon, typical a longer cylindrical one. As if a fractured skull and broken skin isn’t bad enough, compound fractures often come with further complications. In addition to the fractured skull, the meninges can be damaged, causing cerebrospinal fluid to leak out, and increasing the risk of brain infections. Not to mention bone fragments can be spread across the wound. In the vast majority of cases surgery is needed to repair the wound and put the bones back into place.
While Full Metal Alchemist does a slightly better job in regards to head injuries than Naruto in showing an injured Edward from time to time, it still isn’t enough. A Winry love tap should have put Edward in the hospital for a long time, and it runs a risk of causing some degree of damage to the brain itself.
None of you are probably going to be surprised by this, but our favorite action oriented animes get it wrong when it comes to head injuries, especially a skull fracture.
I know I only highlighted Naruto and Full Metal Alchemist, but it tracks across many other anime as well. Take Touma from A Certain Magical Index for example, where Vento probably has a skull fracture.
Vento is not going to be having a very good day after this one. However, it also might just explain why Cure Marine is the way she is.
I realize that I did not talk about hematomas, concussions, CTE, or being punch drunk yet, which I will in part 2 of Head Injuries in anime and it is coming soon. Please leave any comments or questions below.