Coup-contrecoup describes a brain injury in which the brain is bruised in two places on opposite sides of the brain. It happens when the force of the initial impact causes the brain to bounce back into the opposite side of the skull. “Coup” refers to the initial point of injury. “Contrecoup” refers to the point of the second impact. This type of injury can occur with or without a blow to the head.
Common Causes of Coup-contrecoup Brain Injuries
Coup-contrecoup is often an acceleration/deceleration injury. Common causes of coup-contrecoup brain injury include:
- Auto accidents – whiplash
- Falls
- Sports injuries
- Shaken baby
- Assault
Coup-contrecoup brain injury often goes undetected in people who have suffered whiplash in a car accident because all of the attention goes to the neck injury.
Consequences of Coup-contrecoup
Coup-contrecoup injuries can be very serious, even if there is no visible injury or blow to the head. They can lead to hematoma, which is pooled blood in the brain, swelling, and may also involve diffuse axonal injuries in addition to the focal injuries.
The coup-contrecoup focal injuries are more easily detected in imaging tests, but because the diffuse axonal injuries do not show up on traditional imaging tests, doctors may not realize how widespread and extensive the injuries are.
The long-term consequences for those who survive will depend on the area of the brain that are affected.
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