What is Coup-Contrecoup TBI?
Internal and External Sypmtoms
A traumatic brain injury (TBI) is damage to the brain caused by external force.
A coup-contrecoup injury is a specific type of TBI where damage occurs at both the site of impact (coup) and at the site directly opposite (contrecoup).
- Contusions and bruises on sites of impact
- Bleeding/hemorrhaging in brain
- Brain swelling
- Improper flow of cerebrospinal fluid
- Most common contrecoup injury area is frontal/temporal lobes, resulting in problems with:
- Planning/decision making
- Language comprehension and speaking
- Other impairments can include:
- Impaired memory and concentration
- Impaired balance and coordination
- Muscle weakness and sensory damage
More on Mechanisms
How Does It Happen?
- It is a specific type of closed-head injury
- One study found that in a sample of 309 closed-head TBI cases, 57% had a contrecoup injury
- Specific to coup-contrecoup injuries are the severe hemorrhaging due to amount of force
- One theory is that the denser cerebrospinal fluid travels to site of original impact, pushing brain to opposite side
- Another theory is that on impact, "compression waves" travel through the brain, throwing the surface cells on the other side against the skull
- Strong blow against head causes rebound against skull
- Second (contrecoup) impact occurs at site opposite first (coup) impact
- Original force has to be great enough to make brain slam against skull during rebound
- Contrecoup injuries are often overlooked because of location
- Damage is usually severe because of the large amount of force necessary to cause this specific injury
- Common causes:
- Falls and car accidents especially conductive
- Any heavy blow applied to large area
Prognosis and Treatment
- Damage is usually irreversible
- Risk for permanent damage is high
- Injury should be treated right away for best recovery
- Recovery is usually a matter of time and patience (as with all TBIs)
- Treatment is designed to address resulting conditions
- Neurosurgery may be required
- Medication may be required
- TBI is often traumatizing,but improvement is possible
More Facts
- Most common contrecoup injury is to the frontal and temporal lobes due to impact on the occipital lobes
- It is possible for contrecoup to happen by itself
- Permanent damage risk is very high
- Treatment can cost up to millions of dollars
- Very many everyday functions can be affected, depending on injury
Coup-Contrecoup Brain Injury
References
- http://www.tbirecoverycenter.org/coup.htm
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1088202/?page=1
- http://www.northeastern.edu/nutraumaticbraininjury/what-is-tbi/
- https://www.dolmanlaw.com/coup-contrecoup-brain-injuries/
- https://www.google.com/imghp