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A Knock Out as a result of a fist attack can occur with or without loss of consciousness. Usually, it is the consequence of an acute concussive brain syndrome. In the first case, the affected person loses consciousness instantly and remains unconscious for a few seconds. In the second case, the subject does not lose consciousness and remains alert, but nonetheless he is in no way able to keep on fighting.
A concussion (Concussive Cerebral Syndrome) depends on the following factors: the location of the impact, the direction of the blow, the mass of the attacking weapon, the inertia of the head. The most dangerous blows are those that generate a rotational acceleration of the head both on the sagittal plane, as in the case of uppercut punches (photo 1), and on the axial plane, as in the case of hook punches (photo 2).

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When this happens, the brain can undergo violent twisting, stretching and linear acceleration.
The nervous KO. A Knock Out with loss of consciousness can also be the consequence of a vagus nerve stimulation (which leads to a vagal reflex with loss of cardio-circulatory pressure). This stimulation can be caused by blows to the neck (in the area of the carotid sinus) or to the abdomen, i.e., a liver punch with consequent compression of the solar plexus (photo 3). Furthermore, the loss of consciousness can be induced in particular cases by attacks aimed at the orbital region or at the eyeball (photo 4).

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