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  • Writer's pictureRobert Schuerger II

What Is a Contrecoup Injury? A Detailed Explanation

Some of the worst kinds of injuries to deal with are those received to the brain. They can range from mild to severe and affect the ability to function in several ways. Bruising is one thing, but having to deal with a coma or memory loss is another level entirely that strips away what someone's quality of life used to be.

This is why severe traumatic brain injury is treated with such delicacy and urgency by medical practitioners. Coup and contrecoup injuries also fall along the lines of very concerning, which is why they will be addressed below.

Defining a Coup Injury

Defining a Coup Injury

Put simply, this means that the injury received is localized beneath the trauma point. If imagined in the context of a motorist who has hit another head-on at a low speed, the person's head may hit the steering wheel upon impact. Such an occurrence would likely cause a coup injury.

Remember that the crash causes the vehicles to immediately stop, which means that the deceleration force is very significant. Though the hit to the steering wheel would be instant, that doesn't mean that the brain will stop moving.

This means that the brain will hit the point of impact, after which it will reset to its initial position.

Understanding a Contrecoup Brain Injury

Apart from a coup injury, there is also the concept of a contrecoup injury. Instead of the injury taking place at the site of impact, this means that the injury happens at a point opposite the area of trauma.

Now, imagine that a motorist has been rear-ended by another. This would see the force pushing them into their seat and their head going into the headrest instead of into the steering wheel.

With that sudden acceleration, the skull will move to the impact area between the cars, with the brain, of course, moving a bit slower. Therefore, the brain can become bruised from hitting the front of the skull, which is opposite to the trauma point.

How Is a Coup-Contrecoup Injury Caused?

The information provided above essentially means that the terms coup and contrecoup are synonymous with blow and counterblow, with either injury being able to cause some serious problems for the person on the receiving end.

However, these separate injuries can occur together, if the blow to the head happens to be strong enough to cause it to happen.

The brain is encased in the skull and floats in cerebrospinal fluid. This setup is meant to provide enough protection from the general kinds of jolts and bumps that people will experience during the day.

However, some blows to the head are so severe that the brain will just slam against the skull as outlined above.

When both a coup and a contrecoup injury happen together, this is known as a coup-contrecoup injury. In most cases, such injuries will occur when the head is made to strike a stationary object. A good example is when someone is driving and happens to be hit from behind by another car.

In such a case, the contrecoup injury could happen as described before. However, it is possible for a whiplash effect to occur, which would see the driver's head hit the steering wheel. Recall that upon head impact with an object, the brain will move towards the direction of impact until there is a collision with the skull.

The brain can hit the front of the skull and then rebound hard enough to hit the opposite side of the skull. Such injuries are classified in the focal brain variety, which means that they tend to be confined to specific areas of the brain.

Being focal injuries makes them unlike diffuse axonal injury or brain edema, which are on the more extensive side of the fence.

What Do Coup-Contrecoup Brain Injury Symptoms Look Like?

These traumatic brain injuries will affect any two brain regions, which may or may not be exactly opposite to each other. Therefore, people who have this kind of head trauma may find that the effects that happen can be very widespread. A personal injury lawyer in Cincinnati OH can provide more information on this.

The brain has two hemispheres, which can be further divided into four lobes. There are the frontal, perietal, occipital, and temporal lobes. While different areas will collaborate to carry out various brain functions, it's typically possible to pick out a primary region that is responsible for a given function.

Therefore, the symptoms covered below will be based on the specific areas affected and what the functions that are affected may be.

Damage to the Frontal Lobe

The frontal lobe accounts for the greatest portion of the cerebral cortex of the brain. Its responsibilities are along the lines of planning, behavior, memory, attention, and other skills that fall under the cognitive umbrella.

If a coup-contrecoup injury should damage the frontal lobe, the affected person may begin to struggle with any or a combination of the following issues:

  1. Concentration issues

  2. Decision-making issues

  3. Language difficulties (aphasia)

  4. Impulsivity

  5. Judgment impairment

  6. Memory loss

  7. Personality problems

  8. Behavioral issues

Motor control can also be affected by damage being done to the frontal lobe. Therefore, those with these kinds of injuries may find that there is a level of paralysis, weakness, or issues with what would usually be simple voluntary movements.

Damage to the Parietal Lobe

You'll find the parietal lobe behind the front lobe, and this area primarily has the responsibility for the accurate processing of sensory details. This does not only speak to the interpretation of information filtering from sense organs such as your skin or eyes, but it also speaks to proprioception, which is your idea to identify where your body may be in space.

It stands to reason then that when coup-contrecoup injuries occur and affect the parietal lobe, it can create a scenario where interaction with surroundings becomes more difficult than it would be otherwise. Typical symptoms of this kind of damage will include:

  1. Hand-eye coordination challenges

  2. Burning sensations

  3. Abnormalities in the ability to perceive pain

  4. Temperature distinguishing difficulties

  5. Issues with writing, reading, or doing math

  6. Directional challenges

  7. Problems identifying right and left

Damage to the Occipital Lobe

Going further to the back of the brain is the occipital lobe, which is found behind the parietal lobe. Visual stimuli are processed here. Therefore, whenever there is a coup-contrecoup injury that affects this region of the brain, affected parties may find their vision to be distorted or they may begin to experience different variations of blindness.

Some of the most common issues include:

  1. Illusions or visual hallucinations

  2. Challenges with attention or visual recognition

  3. Hemianopsia, which is a form of partial blindness, that may also be called a visual field cut

  4. A reduced peripheral vision range

  5. Alexia (word blindness)

Damage to the Temporal Lobe

In the middle part of the brain is where the temporal lobe is found. It is just adjacent to the temples and is found above the ears. The main function here is auditory information processing. However, it also has a heavy hand in the interpretation of signals received from the eyes and nose.

When there is a coup-contrecoup injury, the following may occur:

  1. Memory loss

  2. Issues with being able to recognize objects or faces

  3. Emotional behavior changes

  4. Challenges with attention

  5. Challenges with spoken language interpretation

  6. Issues with finding correct words

  7. Loss of hearing

Other Symptoms to Note

Remember that these regions of the brain will play a part in different functions that they may not be primarily responsible for. Since a coup-contrecoup injury can affect any brain region, this means that affected parties may find that they experience other secondary challenges, including:

  1. Nausea

  2. Seizures

  3. Speech slurring

  4. Severe headaches

  5. Amnesia

  6. Dizziness

  7. Light and sound sensitivity

  8. Speech slurring

These Injuries Are Not Concussions

Concussions are another form of injury where the brain can be affected by force applied during an accident or some other kind of event that causes a sharp and abnormal impact.

Remember that coup-contrecoup injuries are localized injuries that will specifically affect two regions of the brain. These can be very severe, especially depending on the kinds of issues that the affected person may face when they happen.

Concussions, on the other hand, then to be categorized as mild traumatic brain injuries instead of severe ones.

Nevertheless, some of the symptoms of the two kinds of injuries may align. Nausea, loss of vision, and confusion are a few issues that those who suffer from concussions may experience.

By definition, a concussion is a damaged brain. Therefore, while it may be different from a coup-contrecoup injury, the two are still related.

How Are Coup-Contrecoup Injuries Treated?

Though a coup-contrecoup can be an incredibly severe injury, this is not always the case. The treatment must be tailored to the experience. Therefore, the kind of treatment that is administered will heavily depend on how significant the injury is and which regions of the brain are affected.

Each of these injuries must be treated as unique if the best possible result is to be achieved from the course of treatment administered. Be that as it may, some common methods of rehabilitation are briefly covered below.

Physical Therapy

This will typically be an administered form of treatment if motor control is affected by the presence of the injury. As is the case with other kinds of physical impairment, physical therapy is meant to provide increased mobility based on the targeted exercises that will be performed.

Occupational Therapy

Clearly, the effects that coup-contrecoup injuries can have are pretty widespread and may take away some level of independence from those who are affected. That's why this kind of treatment exists. It's all about restoring as much of that independence to the injured person as possible. This may come through training in new ways of performing everyday activities.

Speech Therapy

As indicated before, aphasia may be one of the results of sustaining a coup-contrecoup injury. If that is the case, then the injured person will lose their ability to communicate effectively. This is why a speech therapist will use various teaching techniques to assist with the regaining of standard language skills. Swallowing skills can also be relearned if necessary.

Cognitive Function

Whenever there are issues with problem-solving, attention, memory, or learning after a coup-contrecoup injury occurs, this kind of therapy is done to help the injured person improve in these areas. Of course, improvements cannot be guaranteed.

Other Essential Treatment Details

Whenever a coup injury occurs, it's always a good idea to work on rehabilitative exercises as much as possible. The idea here is to provide the brain with adequate stimulation to have it understand the demand for these kinds of functions, which can cause it to rewire itself.

Some people may download an app that provides quick access to various exercises that allow for independent practice sessions.

The same can be said about when these injuries affect movements. In such cases, home rehab devices may be helpful throughout the course of treatment.

Coup-Contrecoup Brain Injuries Occur in Many Ways

The technicalities of these injuries have already been explained, as well as the various effects someone who is injured may start to experience. Next is a discussion on a couple of the different occurrences that may see them happening.

Car Accidents

Car accidents are notorious for being able to cause these kinds of injuries since they are typically associated with blunt-force trauma. It's very easy for someone's head to make an abrupt contract with a solid or heavy object when these accidents happen, which means that the brain can start to rattle in the skull and cause a coup-contrecoup injury.

Most commonly, someone's head will hit the steering wheel or dashboard because of a whiplash effect. As indicated before, that kind of motion can cause the brain to impact the skull in two places.

If a negligent driver was the reason that this happened to someone, the injured party may be able to claim compensation for the injury and other circumstances.

Slip and Fall

A slip and fall can also be the reason for these kinds of injuries to occur. That's because the head can hit a surface or heavy object. Imagine someone slipping on a well-polished floor and hitting their head on the said floor.

It stands to reason that this is enough to cause the brain to bounce in the head, which means that the brain can forcibly hit the area of impact and the opposite side.

As was the case with the car accident, the slip and fall may have happened because a property owner was negligent, which means it may be possible to file a personal injury claim for compensation.


The track record that impact sports have is well known. Of course, the force generated can cause the brain to hit two separate areas resulting in a coup-contrecoup injury. Other brain injuries such as concussions are also very common in certain sports including boxing, hockey, and football.

Do Not Ignore Any Head Injury

Do Not Ignore Any Head Injury

As indicated before, motor vehicle accidents, alongside other occurrences can cause a laundry list of potential symptoms depending on what kind of scenario occurred.

While some of these effects may be temporary and a mild inconvenience, others can be very severe and even potentially fatal.

It's not possible to identify the extent of the damage from a head injury simply by going off what feeling may be present at a particular time. It takes a proper medical evaluation to understand what kinds of challenges are or may become present in the future.

That's why any person who has been in an accident is advised to get medical attention as quickly as possible. Doing so minimizes the possibility of problems arising that could be avoided with quick care. Of course, it does not mean that everything will be taken care of as some effects of coup injuries can only be worked around and not corrected.

If the accident occurred because someone else was negligent, getting medical attention also provides proof of the injury and the kind of treatment needed as well as a breakdown of the costs associated with the treatment. This means that there is adequate documentation that will play a big part in seeking compensation through filing a personal injury claim.

Schedule a Free Consultation with a No-nonsense Ohio Personal Injury Lawyer Today!

Cleary, a coup-contrecoup injury is nothing to ignore considering the sheer impact it can have on someone's quality of life. If this injury was the result of someone else's negligent actions, it may be possible to claim both economic and non-economic damages based on the various effects that the accident has had. Schuerger Shunnarah Trial Attorneys can also share information on the catastrophic injury legal definition.

Such damages may include property damage, medical bills, loss of wages, loss of enjoyment, pain and suffering, etc.

However, doing this successfully means retaining the services of the kind of Ohio attorney who will go to war for you. Schuerger Shunnarah Trial Attorneys has a team with the qualifications and experience necessary to get the best possible outcome!

Schedule a free consultation today!


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