I read your query and I am sorry for your friend. There are two possibilities. The first one is that hitting the head he has had traumatic brain injury. Concussion is one type of traumatic brain injury, but if he hasn t regained consciousness at all it must be more serious. To judge the degree and the need for any surgical intervention of course he has to have at least a CT scan, which you don t mention. If he has done it perhaps the damage is not of the sort which benefits from surgery, in that case treatment is only with drugs trying to prevent brain swelling, if that is the case it s not your doctors fault, that s all that can be done, improvement will need its time depending on the severity of damage. It depends on results of CT scan though, so I can t be more precise. Second possibility is his being in an epileptic status, meaning uninterrupted seizures, in that case treatment is with anti-epileptics and airway protection, at times can be a medication induced coma to stop the seizures and the brain swelling. If he has seizure activity it s easy to identify, but if no seizure activity and CT doesn t explain his non-waking up then a non-convulsive epileptic status needs to be considered which needs an EEG to confirm. Anyway, I hope I m not confusing you even more, I know it s too many hypotheses, but as I said to be more precise at least the CT scan is needed. I hope things will go for the best.