What Is a Coup-Contrecoup Brain Injury?

Ryan Zavodnick | January 17, 2024 | Brain Injuries

A coup-contrecoup injury is a common type of traumatic brain injury or TBI. It’s usually the result of a sudden, violent movement or a blow to the head from a fall, sports injury, or a car accident. Coup-contrecoup injuries are actually two injuries combined: a coup injury and a contrecoup injury. 

Coup-Contrecoup Brain Injuries

A coup-contrecoup brain injury is two injuries that occur at nearly the same time: a coup injury followed by a contrecoup injury. 

Coup Brain Injury

This injury refers to damage directly below the site of a blow to the head. Coup injuries are usually associated with a moving object that hits the head while it’s stationary. 

Contrecoup Brain Injury

A contrecoup injury happens when the initial impact or forceful movement causes the brain to move within the skull and strike the opposite side of the skull. It causes damage that’s usually directly opposite from the initial site of impact. 

Contrecoup injuries are usually associated with a moving head striking a stationary object, such as hitting the dashboard, steering wheel, or window in a car accident. 

Coup-Contrecoup Brain Injury

Coup and contrecoup injuries can happen on their own. Sometimes, however, they happen together in what is known as a coup-contrecoup injury. 

The two injuries are not necessarily the same in terms of severity. The initial coup injury may be mild while the contrecoup injury is more serious or vice versa. Most often, the contrecoup injury is more severe than the coup injury. 

Common Causes of Coup-Contrecoup Injuries

Coup-contrecoup injuries can occur in many ways, but they usually require significant force and/or rapid acceleration and deceleration. The most common causes of coup-contrecoup brain injuries include: 

• Car accidents
• Motorcycle accidents
• Pedestrian accidents
• Bicycle accidents
• Sports accidents
• Falls
• Workplace accidents

Assault or a severe blow to a head that isn’t moving usually does not cause a contrecoup injury. The head isn’t accelerating or decelerating, and the brain doesn’t lag, so it’s unlikely to continue moving in the cerebrospinal fluid and strike the opposite side of the skull. 

Most coup-contrecoup injuries occur in motor vehicle accidents or falls, both of which are likely to cause a blow to the head and rapid acceleration-deceleration. 

The Wide-Ranging Symptoms of Coup-Contrecoup Brain Injuries

A coup-contrecoup injury usually affects two different regions of the brain. Although all regions of the brain work together, each region has a range of primary functions. The symptoms and long-term effects of coup-contrecoup brain injuries can depend on the regions affected and the severity of the damage, but they also vary by person. 

Here are the areas of the brain that may be affected by a coup-contrecoup injury and common symptoms and effects. 

Frontal Lobe

The frontal lobe is responsible for higher cognition like behavior, memory, planning, and attention. It’s usually injured more often than other regions of the brain. 

Injury to the frontal lobe can cause: 

• Memory problems
• Difficulty concentrating
• Impulsive behavior and poor judgement
• Language problems
• Changes to personality or behavior
• Difficulty with decision-making

It’s also common for these injuries to affect motor control. 

Occipital Lobe

The occipital lobe at the back of the head is mostly responsible for visual perception and processing motion, form, and color stimuli. Damage to the occipital lobe can cause many forms of blindness or visual changes like partial blindness, reduced peripheral vision, hallucinations, trouble locating objects or identifying colors, or difficulty tracking movement. 

Temporal Lobe

The temporal lobe is mainly responsible for processing auditory stimuli, but it’s also involved in olfactory and visual processing. Damage to the temporal lobe can cause hearing loss, trouble understanding language, and difficulty speaking or finding the right words. It can also affect attention, memory, visual processing, and more. 

Parietal Lobe

This brain region processes sensory information related to your sense of space and sense of touch. Perception, sensation, movement, and location awareness can be affected by parietal lobe damage. 

The parietal lobe is usually not affected by traumatic brain injuries, especially car accidents, due to its location at the crown of the skull or the top rear of the head. 

Contact a Personal Injury Lawyer for a Free Initial Consultation

Coup-contrecoup injuries are often very serious, as more than one area of the brain is affected. Prompt treatment is important to relieve inflammation and pressure and reduce the risk of further brain damage. 

If you have suffered a coup-contrecoup brain injury in an accident, contact the Philadelphia brain injury lawyers at Zavodnick & Lasky Personal Injury Lawyers at (215) 875-7030 to schedule a free consultation today.