Coup and Contracoup Brain Injury

An accident, be that on the road or at work, that involves a sharp, sudden or violent stop, braking or an impact with an object, can cause the brain to move forward inside the skull and impact with the front of the skull. This is known as a coup injury.

Whereas, a contracoup brain injury causes impact when the brain moves forward at speed into the front of the skull and then moves back into the rear of the skull causing impact injuries to both the front and back of the brain.

Both a coup and contracoup brain injury causes damage to the brain tissue as the impact causes contusions against the inner ridges of the skull. Contusions are a form of bruise where blood vessels are ruptured.  A coup injury causes a contusion in the frontal lobes at the site of impact. A contracoup impact will tend to show contusions on the opposite side of the impact.

It is possible to sustain both a coup and contracoup brain injury in the same impact. The injuries are often found in the frontal and temporal lobes.

Both injuries can cause further injury to the brain such as larger haematomas and swelling of the brain. These injuries are associated with the cognitive, emotional and behavioural deficits common to brain injury such as:

• Memory difficulties

• Concentration and attention difficulties

• Difficulties with balance and coordination

• Aggression

• Visual and speech difficulties.

Coup and contracoup injuries often cause permanent damage to the brain; a life changing injury.