Coup contrecoup injury: Difference between revisions
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==Background== | ==Background== | ||
*Type of TBI | *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 Features== | ==Clinical Features== | ||
*TBI like symptoms | *[[TBI]] like symptoms | ||
*Headache | *[[Headache]] | ||
*Visionary discomfort | *[[visual disturbances|Visionary discomfort]] | ||
*Nausea | *[[Nausea/vomiting]] | ||
*Dizziness | *[[Dizziness]] | ||
*Fatigue | *[[Fatigue]] | ||
*Uneven gait | *[[ataxia|Uneven gait]] | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
*[[Concussion]] | *[[Concussion]] | ||
*Skull Fracture | *[[Skull Fracture]] | ||
{{Intracranial hemorrhage DDX}} | {{Intracranial hemorrhage DDX}} | ||
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==Evaluation== | ==Evaluation== | ||
===Labs and Imaging=== | ===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 See== | ||
Revision as of 00:42, 3 October 2019
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