Just one punch can lead to such devastating consequences.
From broken jaws and fractured skulls, single acts of violence in the region have not only caused long-lasting serious injury.
Some families will know how lucky they are that their son or daughter survived their injuries, but other families have had their lives wrecked.
Lives have been lost with a number of victims unable to recover from the horrific injuries they sustained from a single punch.
While some one-punch attackers have faced time behind bars, others have been able to walk free from court.
We take a look at seven people who have been brought before the courts across the North East in recent years for a one-punch attack.