In a matter of minutes last Saturday when Colin Byars tried defending a group of women outside a Kenosha tavern, his name became synonymous with Nino Sustache.

It’s a scene that law enforcement officers and rescue workers seem to be seeing more often, and it’s a reminder that even one punch can have dangerous consequences.

“This goes to show you how a relatively innocuous thing like a punch to the face potentially can have such a lethal result,” Kenosha police Sgt. Hugh Rafferty said. “In light of what’s happened, maybe it serves as a general warning to everyone.”

Rafferty said on Friday afternoon that Kenosha authorities have yet to make any arrests in Byars’ case, but the investigation is continuing. Police have said they believe they’ve identified three people responsible.

“We’re making progress each day,” Rafferty said.

According to police reports, Byars, 24, had left a tavern on the corner of 30th Avenue and Roosevelt Road, at about 2:20 a.m. Saturday when he apparently stood up to the suspects who accosted some females in Byars’ group.

Byars died after he fell and hit his head on a concrete curb, thus suffering the same tragic fate Sustache, 17, did when he was punched in the face and fell on a sidewalk during a 2004 New Year’s Eve party.

The 16-year-old Bradford student who punched Sustache was charged with aggravated battery and later sentenced to 30 days detention. He also was put on house arrest and ordered to have counseling and do community service, including 100 hours with brain-damaged children.

“Lots of people that get punched end up with a bruise or sore jaw, even if they fall, even if they hit their head,” said Kenosha County Medical Examiner Dr. Mark Witeck. But in some cases, it’s the combination of the punch and the trauma caused to the skull or brain that proves lethal.

In such cases, the victim suffers a skull fracture when they hit their head. But the injury is compounded because the brain moves around inside our heads. One blow could throw the brain into the backs of our skulls and then to the front, causing two impacts.

“The brain can slosh around,” Witeck said, adding that swelling comes next. “The problem then is your brain is going to swell, but it really doesn’t have much to go.”

In fact, the only place the brain could go is the brain stem, which is about the size of your pinky finger. Sometimes even the best neurologist with the best treatment plans can’t stop such swelling, Witeck said.

Not all cases like the ones involving Byars and Sustache end in death, noted Charles Cady, the medical director for the Kenosha Fire Department and an assistant professor for emergency medicine at the Medical College of Wisconsin/Froedtert Hospital.

He estimated the Kenosha Fire Department gets called about once a month to emergencies involving people who have fallen and hit their heads. Someone who is punched and knocked out usually regains consciousness within a few minutes, Cady said.

“I think more often than not it tends to be the fall that causes the significant injury,” Cady said. “However, I think if you can punch someone in just the right spot with the right force it can cause that as well.”

Alcohol may play a factor, experts said, although its role factors more into the victim’s ability to make decisions or keep one’s balance than the severity of the injury.

“If somebody punches you and you’re completely sober, you might have good balance to keep yourself up,” Cady said. “Even if you have one drink it limits your ability to respond as quickly as you normally would. I think we see that with any type of crime or any type of injury.”