Coup-Contrecoup Car Accident Brain Injuries

What is a coup injury?

Coup injuries are commonly a focal brain injury. The damage is most commonly caused by a moving object striking the head while the head is motionless.

The damage happens directly below the area of the head that was impacted. This results is bruising, contusions and lacerations to the brain tissue.

In most cases visual injury to the head and scalp can be seen above the internally damaged area of the brain. This helps medical professionals identify a coup injury.

However, the absence of observable injury does not negate the possibility of interior damage.

Coup injuries can occur through acceleration or deceleration. In this situation the head did not strike a object and external damage would not appear. Whiplash is a perfect example of this. Whiplash can cause brain injury.

The brain floats in cerebral fluid inside our head. The sudden and violent jolting of the head during a car accident causes the brain to hit the harder inner skull. This leads to bruising, inflammation and other forms of tissue degeneration.

While coup injuries are possible without impact, most occur as a result of a blow to the head.

Coup injuries make the most sense to us. Our head is hit and the damage occurs right below it. The more confusing and less understood brain injury is the contrecoup.

What is a contrecoup injury?

Contrecoup injuries are also focal brain injuries. The damage is most commonly caused when the head is moving and hits a solid object.

In this case however, the damage is on opposite side of the impact. This results in the same bruising or bleeding within a person’s skull. Brain bleeds can prove deadly for the victim if not treated.

External personal injury may not been noticeable above the area where the brain is damaged because the impact was to the opposite side of the head.

The only visual indicator of contrecoup on the head would be swelling. This would be a severe case of contrecoup.

Since contrecoup normally displays no external damage it is more difficult to identify and treat. Diagnosis using MRI and Cat Scan is necessary.

Contrecoup injuries are most commonly encountered in slip fall accident injuries or motor vehicle accidents. In these instances the head is moving so rapidly that when it strikes a solid object damage happens on the other side of the brain.

A head-on vehicle collision is a good example. The forehead will collide with the steering wheel and shows signs of impact.

Internally, the entire brain was violently pushed around inside the skull. Limited space for movement results in the brain impacting the skull opposite the area of contact with wheel.

Contrecoup is difficult to identify for two reasons. The first reason is the affected area of the brain typically shows no externally visual damage. Secondly, contrecoup happens frequently in more severe accidents where coup-contrecoup is present.

What is a coup-contrecoup injury?

Coup-Contrecoup injuries cause the brain to endure focal damage in multiple areas. Damage is directly below and opposite the site of impact.

This is diffuse axonal injury because it happens in multiple areas of the brain. Swelling is common and leads to further damage.

Symptoms of further damage due to swelling can take days after the accident to appear. Delayed injuries are a common side-effect of hidden brain injuries.

Head trauma of this type is caused by an extremely intense impact that not only damages the area below the site of contact, but on the opposite side of the brain as well.

Coup-contrecoup is classified as a moderate to severe form of TBI for this reason.

More severe accidents are typically the cause of coup-contrecoup. Examples would be high speed vehicle collisions or a slip-and-fall where the head impacts the hard floor directly.

The misdiagnosis of coup-contrecoup is not uncommon. Medical professionals focus will usually be on the area of visual damage.