Coup contrecoup injury

Background

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
  • Contrecoup: opposing side injury from movement of the brain and cerebral spinal fluid shift from translational forces

Clinical Features

Differential Diagnosis

Intracranial Hemorrhage Types

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

References