What Is a Coup-Contrecoup Brain Injury?

June 21, 2023 | Attorney, Matthew Dolman
What Is a Coup-Contrecoup Brain Injury?

Head injuries can be categorized into two types of injuries: a coup injury or a contrecoup injury. A coup injury happens at the point of impact with an object, whereas a contrecoup injury takes place on the opposite side of the skull from the impact. These types of injuries are often associated with cerebral contusions where the brain is bruised.

A coup-contrecoup injury is a type of traumatic brain injury (TBI) that can occur when the head experiences a sudden and violent movement, such as in a car accident, sports injury, or fall. Coup-contrecoup injuries can arise either separately or together. When a stationary head is hit by a moving object, coup injuries usually occur, while contrecoup injuries happen when a moving head hits a stationary object.

What is a Coup Injury or a Contracoup Injury?

A coup injury occurs at the site of impact, where the force of the impact is directly transmitted to the brain tissue. For example, if the front of the head is struck, a coup injury may occur at the front of the brain.

In contrast, a contrecoup injury occurs on the opposite side of the brain from the site of impact. This happens because the force of the initial impact causes the brain to move within the skull, hitting the opposite side of the skull and causing injury to the brain tissue at that site. For example, if the front of the head is struck and the brain is jolted backward, a contrecoup injury may occur at the back of the brain.

Most brain injuries result from an outside force, meaning something comes in contact with the head. This impact, and the resulting injuries, fall into three different medical definitions:

  • coup
  • contrecoup
  • coup-contrecoup.

[Common Misspellings: coo, contracoo, contracoup, coo injury, coop injury, contracoop, contracoo, contrecoo, conracoo brain injury]

It's important to note that these traumatic brain injuries are considered non-penetrating injuries. Coup and contrecoup injuries are most commonly caused by a fall, blunt force trauma, a sports injury, or the force associated with a car crash or motorcycle accident. Before we move on with the difference between these three terms, it may help to familiarize yourself with some more common terms associated with TBI.

What Is the Difference Between a Coup and Contrecoup Injury?

  • Coup injuries – Coup injury occurs on the brain directly at the site of the impact. Locating brain bruises, cuts, contusions, or other marks can help to pinpoint the location. Trauma can range from relatively mild to severe, including bruising, brain swelling, and hemorrhaging of the brain.
  • Contrecoup injuries – Injuries resulting from a blow to the head that causes the brain to hit the opposite side of the skull from the point of impact are known as contrecoup injuries. These injuries are often overlooked or misdiagnosed due to their location and can be caused by motor vehicle rollovers, rear-end crashes, or motorcycle accidents. If not identified, these injuries can have long-term consequences for victims.
  • Coup-Contrecoup injuries – The damage from this type of head injury occurs to the side of the impact and the opposite side when the brain strikes the skull. Coup-contrecoup injuries are often misdiagnosed, resulting in one area being treated and the other overlooked. Permanent brain damage risks are very high with coup-contrecoup injuries.
Coup and Contrecoup Brain Injuries
ARROW represents the impact point, and RED CIRCLE represents the injury point

What Can Cause a Coup Contrecoup Injury?

Coup contrecoup injuries occur when a blow to the skull leads to brain damage in multiple areas. In some cases, these types of injuries can damage two sides of the brain. For this to occur, the brain must experience severe blunt force trauma by coming into contact with a heavy object.

The following are some of the ways brain damage can cause a coup-contrecoup injury:

Coup-Contrecoup Injuries and Car Accidents

The impact of a car accident can result in the skull receiving blunt force trauma. Whether the skull received direct trauma from the car or came into contact with a heavy object, the impact of the blow can cause the brain to rattle inside the skull and lead to a coup-contrecoup injury.

The most common way to receive a coup-contrecoup injury during a car accident is when your head comes into contact with the steering wheel or dashboard. The whiplash of a car accident can send your head into the steering wheel or dashboard, resulting in the brain receiving damage that sends it rebounding to the other side of the skull.

A Slip and Fall Can Cause a Coup-Contrecoup Injury

When you experience a slip-and-fall accident, your head may collide with a heavy object or surface. For example, you may slip on water and bang your head on a linoleum floor. The trauma can bounce your brain, causing it to collide with the skull at the impact area and on the opposite side. This can cause a coup-contrecoup injury.

If a property owner's negligence led to your slip and fall accident and coup-contrecoup injury, you could file a claim with their insurance company to recover compensation. Property owner negligence can include leaving water on the floor without signage indicating the floor is wet or failing to maintain the premises in a safe condition.

Sports Activities Can Lead to a Coup-Contrecoup Injury

Impact sports are known for causing trauma that can have a serious impact on the brain. Concussions and other traumatic brain injuries are common in sports such as football, hockey, and boxing, where the brain can receive a blow during the activity.

For example, players may suffer a coup-contrecoup injury during a football game. A receiver may be running with the ball and lower their head to run through a would-be tackler. If the tackler lowers their head, the high-speed impact can force the brain to impact the skull and cause a coup-contrecoup injury.

What is the Difference Between a Coup-Contrecoup Injury and a Concussion?

The human brain is a delicate organ that is shielded by the skull and the surrounding cerebrospinal fluid. When the head is subjected to an abrupt force, such as in a car accident, the brain can be jarred within the skull, similar to the way water sloshes back and forth in a bucket when it is hit on the side. This violent movement can cause serious trauma to the brain if the force is powerful enough. Coup and contrecoup injuries are strongly related to concussion injuries.

Concussions are often categorized as mild traumatic brain injury, which means they aren't necessarily life-threatening — this doesn't mean that they don’t have catastrophic effects. After a concussion, your brain doesn't function normally, and you may experience a loss of vision, nausea, loss of balance, confusion, and loss of consciousness.

Since a concussion, by definition, is a bruised or damaged brain, it is strongly related to coup contrecoup injury.

What are the Symptoms of a Coup Contrecoup Brain Injury?

Coup-contrecoup brain injuries can have severe symptoms that can manifest in the days and weeks following a trauma. Ignoring a mild concussion can be fatal if a second injury occurs in the same area before healing.

Here are some of the symptoms to watch for if you suspect a coup-contrecoup brain injury:

  • Intense headaches
  • Dizziness
  • Memory loss
  • Loss of consciousness
  • Sensitivity to light
  • Sensitivity to sound
  • Vision problems
  • Muscle weakness
  • Ringing in the ears
  • Difficulty with language comprehension
  • Impaired concentration
  • Trouble swallowing

Never Ignore Head Trauma — Even a Mild Concussion

Traumatic brain injuries of any type are extremely serious. TBI symptoms can be delayed and varied — some may not appear for days or even weeks following your injury. Never ignore a bump on the head; you may have a serious injury and risk permanent damage.

You should seek medical attention immediately if you experience pain that lasts for more than a few minutes or if you experience other symptoms. You should go to the emergency room following a concussion if you have nausea, vomiting, dizziness, blurry vision, or speech difficulties. The severity of coup-contrecoup injuries means that it is essential to identify and treat them quickly. Any delay can lead to a range of serious consequences, such as brain bleeding, swelling, and pressure on the brain, as well as fragments of the skull entering the brain tissue.

Coup-contrecoup injuries, which are most frequently experienced in the frontal lobe and temporal lobes, can lead to a variety of difficulties, including problems with decision-making, verbal communication, memory, coordination, and sensation. Depending on the extent of the trauma, additional symptoms like difficulty swallowing, paralysis, and impaired concentration may also occur.

The following are some of the financial losses and legal damages you could pursue in a coup-contrecoup injury claim:

Economic Damages

The effects of a coup-contrecoup injury can inflict severe damage and significantly reduce your overall quality of life. Many coup-contrecoup injuries can cause permanent effects that can affect someone through the entirety of their life. Brain damage can lead to some of the worst economic damages possible.

The medical costs for coup-contrecoup injuries are usually extensive because of the long-lasting debilitating effects they can have that require medication and therapy. Careers are often lost, and income potential is ruined because of the disabilities that a coup-contrecoup injury can inflict.

The following are some of the economic damages you could pursue in a coup-contrecoup injury claim:

Non-Economic Damages

A coup-contrecoup injury can also lead to non-economic damages that can be more complicated to value. The mental anguish of these injuries can negatively affect a person's mental health, not to mention their relationships, social lives, and enjoyment of life in general. These non-economic damages related to a coup-contrecoup injury deserve compensation when they arise because of the negligent actions of another party.

Coup, Contrecoup, and Coup-Contrecoup Injuries

Treating a Coup, Contrecoup, or Coup-Contrecoup Injury

Treating the damage caused by a serious coup, contrecoup, or coup-contrecoup injury is a battle of time and prevention since the damage is usually irreversible. Your injuries must be treated by a medical professional immediately so that a diagnosis can be made and treatment can be administered as soon as possible. 

Your doctor can determine the damage caused by the coup-contrecoup injury with a CT scan. Doctors may advise that you employ at-home recovery methods like rest and medications to reduce symptoms. Depending on the severity of your case, they may decide to perform neurosurgery to decrease brain swelling or bleeding.

A Coup-Contrecoup TBI Injury Can Lead to Long-Term Costs

A TBI's cost can create lifelong financial difficulties— totaling millions of dollars. Victims may experience permanent disability, rehabilitation, re-learning, career re-training, and dependency on others. The pain and suffering these injuries can cause cannot be understated.

Because of this long-term and debilitating damage, those harmed by coup-contrecoup injuries caused by another person's negligence can seek compensation under the law. Personal injury claims and lawsuits can help you receive the compensation you need to contend with the severe damages inflicted by coup-contrecoup and other brain injury types.

Car accidents, trips and falls, and on-the-job accidents can all be the source of coup-contrecoup injuries and can be caused by other parties who may owe you restitution for their negligence. Consider speaking to a personal injury lawyer about your case and what legal options are available to you.

A Coup-Contrecoup Injury Lawyer Can Help You Recover The Compensation You Deserve

The claims process involved in recovering damages is complicated and can place additional stress on victims as they recover from a coup-contrecoup injury. Recovering from such a severe injury while pursuing compensation from an insurance company is challenging because your mind is not in the right place to handle in-depth legal procedures. A coup-contrecoup injury also may cause cognitive functioning problems that make you incapable of representing yourself.

A coup-contrecoup injury lawyer can navigate the claims process for you and use their legal expertise to help you pursue compensation. While recovering from your traumatic brain injury, your dedicated brain injury attorney can determine the best path for recovering compensation. However, you must act quickly; statutes of limitation deadlines apply to your case.

The following are some of the ways a coup-contrecoup injury attorney can help you with your claim:

  • Determine the at-fault party: Before you can recover compensation, your coup-contrecoup injury lawyer will need to identify the at-fault party that caused your injury. They will examine the specifics of the accident that caused your coup-contrecoup injury to decide what party caused your injury through negligent behavior. Once they determine the liable party, your brain injury attorney can assess your damages, determine what compensation you should seek, and send a demand letter to the insurance company.
  • Collect evidence to prove liability: Your lawyer must prove that the at-fault party's negligent behavior caused your injury to receive compensation for your coup-contrecoup injury. They can collect evidence, such as video footage, photos, witness testimonies, ticket and arrest records, medical records, and vehicle accident reconstructions.
  • Negotiate the settlement: The insurance company may try to limit your settlement to keep its profits up. They will probably offer an initial lowball settlement. Your coup-contrecoup injury lawyer can help negotiate a fair settlement by proving the at-fault party caused your injuries through negligent behavior and explaining the full extent of your losses.
  • Represent you in court: Exceptional TBI lawyers must be skilled trial advocates who will not hesitate to represent you in a court of law if necessary. If you and the insurance company cannot settle, your case will go to court. Your coup-contrecoup injury lawyer can represent you in the lawsuit by constructing a solid trial strategy, delivering an emphatic opening statement, examining witnesses, and helping to prove you deserve compensation for your coup-contrecoup injury.

Contact Dolman Law Group for Help With Your Coup-Countrecoup Injury Claim

If you or a loved one suffered a catastrophic brain injury due to an accident caused by someone else's negligence, you need to speak with a personal injury attorney who is qualified to handle coup-contrecoup injury lawsuits. A qualified brain injury attorney knows the true cost of your injury over a lifetime and will fight for every dime possible.

At Dolman Law Group Accident Injury Lawyers, PA, our brain injury lawyers are willing to fight relentlessly to recover the money you truly deserve — even if it means waging a court battle on your behalf. If you or someone you care about suffered a traumatic brain injury through the fault of another party, you owe it to yourself to call Dolman Law Group Accident Injury Lawyers, PA, for a free consultation.

Do not hesitate; time can erase the evidence, and deadlines apply. Call our office at (727) 451-6900 or fill out our contact form online.


Matthew Dolman

Personal Injury Lawyer

This article was written and reviewed by Matthew Dolman. Matt has been a practicing civil trial, personal injury, products liability, and mass tort lawyer since 2004. He has successfully fought for more than 11,000 injured clients and acted as lead counsel in more than 1,000 lawsuits. Always on the cutting edge of personal injury law, Matt is actively engaged in complex legal matters, including Suboxone, AFFF, and Ozempic lawsuits.  Matt is a lifetime member of the Million Dollar Advocates Forum and Multi-Million Dollar Advocates Forum for resolving individual cases in excess of $1 million and $2 million, respectively. He has also been selected by his colleagues as a Florida Superlawyer and as a member of Florida’s Legal Elite on multiple occasions. Further, Matt has been quoted in the media numerous times and is a sought-after speaker on a variety of legal issues and topics.

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