Coup contrecoup injury: Difference between revisions
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==Background== | ==Background== | ||
*Type of TBI | [[File:Coup injury.jpg|thumb|When the head strikes a fixed object, the coup injury occurs at the site of impact and the contrecoup injury occurs at the opposite side.]] | ||
*Type of [[TBI]] | |||
*Coup: injury site on the side of the blunt force mechanism | *Coup: injury site on the side of the blunt force mechanism | ||
*Contrecoup: opposing side injury from movement of the brain and cerebral spinal fluid shift from translational forces | *Contrecoup: opposing side injury from movement of the brain and cerebral spinal fluid shift from translational forces | ||
==Clinical | ==Clinical Features== | ||
*TBI like symptoms | *[[TBI]] like symptoms | ||
*Headache | *[[Headache]] | ||
*Visionary discomfort | *[[visual disturbances|Visionary discomfort]] | ||
*[[Nausea/vomiting]] | |||
*Dizziness | *[[Dizziness]] | ||
*Fatigue | *[[Fatigue]] | ||
*Uneven gait | *[[ataxia|Uneven gait]] | ||
== | ==Differential Diagnosis== | ||
*[[Concussion]] | *[[Concussion]] | ||
* | *[[Skull Fracture]] | ||
==Labs and Imaging== | {{Intracranial hemorrhage DDX}} | ||
==Evaluation== | |||
===Labs and Imaging=== | |||
*Trauma Labs depending on history (or lack there of) | *Trauma Labs depending on history (or lack there of) | ||
==Management== | ==Management== | ||
*Assess for additional injuries | *Assess for additional injuries | ||
* | *[[Analgesia]] | ||
* | *Consider neurosurgery, trauma consult depending on degree of injury | ||
==Disposition== | ==Disposition== | ||
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*Home if at baseline, no additional injuries | *Home if at baseline, no additional injuries | ||
**Inform about post-concussive symptoms | **Inform about post-concussive symptoms | ||
*Outpatient | *Outpatient concussion/head trauma clinic if available | ||
==Also | ==See Also== | ||
*[[Head trauma (main)]] | |||
*[[Concussion]] | *[[Concussion]] | ||
*[[Head CT in Trauma (Clinical Decision Rules)]] | *[[Head CT in Trauma (Clinical Decision Rules)]] | ||
| Line 42: | Line 42: | ||
*[[EBQ:Canadian Head CT Rule]] | *[[EBQ:Canadian Head CT Rule]] | ||
==References== | |||
[[Category:Trauma]] | [[Category:Trauma]] | ||
[[Category: | [[Category:Neurology]] | ||
Latest revision as of 19:54, 11 November 2020
Background
- Type of TBI
- Coup: injury site on the side of the blunt force mechanism
- Contrecoup: opposing side injury from movement of the brain and cerebral spinal fluid shift from translational forces
Clinical Features
- TBI like symptoms
- Headache
- Visionary discomfort
- Nausea/vomiting
- Dizziness
- Fatigue
- Uneven gait
Differential Diagnosis
Intracranial Hemorrhage Types
- Intra-axial
- Hemorrhagic stroke (Spontaneous intracerebral hemorrhage)
- Traumatic intracerebral hemorrhage
- Extra-axial
- Epidural hemorrhage
- Subdural hemorrhage
- Subarachnoid hemorrhage (aneurysmal intracranial hemorrhage)
Evaluation
Labs and Imaging
- Trauma Labs depending on history (or lack there of)
Management
- Assess for additional injuries
- Analgesia
- Consider neurosurgery, trauma consult depending on degree of injury
Disposition
- Often kept for observation
- Home if at baseline, no additional injuries
- Inform about post-concussive symptoms
- Outpatient concussion/head trauma clinic if available
See Also
- Head trauma (main)
- Concussion
- Head CT in Trauma (Clinical Decision Rules)
- Head CT interpretation
- EBQ:Canadian Head CT Rule