What Are Coup and Contrecoup Brain Injuries?

March 16, 2023 | Attorney, Matthew Dolman
What Are Coup and Contrecoup Brain Injuries?

Head injuries can result in two types of injuries: coup and contrecoup injuries. A coup injury happens beneath the point of impact with an object, whereas a contrecoup injury takes place on the opposite side of the area that was hit. These types of injuries are often associated with cerebral contusions, a kind of traumatic brain injury where the brain is bruised. Coup and 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.

Coup and contrecoup injuries are types of traumatic brain injuries (TBI) that can occur when the head experiences a sudden and violent movement, such as in a car accident, sports injury, or fall.

A coup injury is a brain injury that 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, come in three different types:

  • 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 Coup and Contrecoup Injuries?

  • Coup injuries – Coup injury occurs on the brain directly below the site of the impact. The surface 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 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 under 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

Causes of Coup-Contrecoup Injuries

Coup-contrecoup injuries occur when a blow to the skull leads to brain damage. 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.

Coup-Contrecoup Injuries After a Slip and Fall

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 rattle 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 damages. This negligence can include leaving water on the floor without signage indicating the floor is wet.

Coup-Contrecoup Injuries Can Occur During Sports Activities

Sports are known for the effects the trauma caused by the activity can cause on the brain. Concussions and other traumatic brain injuries are common in sports where the brain can receive a blow during the activity.

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

Coup-Contrecoup Injuries and Concussions

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 rattled and jarred within the skull, similar to the way water sloshes back and forth in a bucket when it hits 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 unconsciousness.

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

Symptoms of a Coup-Contrecoup Brain Injury

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

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

You must seek medical attention immediately if you experience pain that lasts for more than a few minutes or if you experience other symptoms. Reasons to go to the emergeny room following a concussion include 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, as a 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.

Damages Caused by Coup and Contrecoup Injury

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 damages you could pursue in a coup-contrecoup injury claim:

Economic Damages

These effects of a coup-contrecoup injury can inflict severe damage and significantly reduce a person's 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 expenses for coup-contrecoup injuries are extensive because of the long-reaching 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

There are also the non-economic damages one can suffer because of a coup-contrecoup injury. 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. All of these damages caused by a coup-contrecoup injury deserve compensation when they are suffered because of the negligent actions of a liable party.

Coup, Contrecoup, and Coup-Contrecoup Injuries

Treating Coup, Contrecoup, and Coup-Contrecoup Injuries

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

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 Cause Long-Term Costs

A TBI's cost can present itself as 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 that these injuries can cause cannot be understated.

Because of this long-term and debilitating damage, those harmed by coup-contrecoup injuries caused by others' negligence can seek compensation. Personal injury claims can get you the compensation you need through settlements or court awards 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 liable parties that 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 can be complicated as you recover from your 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 take on the claims process and use their legal expertise to help you pursue compensation. While recovering from your traumatic brain injury, your brain injury attorney can determine the best path for recovering compensation. However, you must act quickly; statutes of limitation may 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 determine who the at-fault party is 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 the 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 could offer an initial lowball settlement. Your coup-contrecoup injury lawyer can help negotiate a fairer settlement offer by proving the at-fault party caused your injuries through negligent behavior.
  • Represent you in court: Our lawyers are skilled trial advocates and will not hesitate to represent you in a court of law, if necessary. If you and the insurance company cannot settle, the case will go to court. Your coup-contrecoup injury lawyer can represent you in the lawsuit by constructing the plan, 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 cataclysmic brain injury due to an accident caused by negligence, you need to speak with a personal injury attorney who is qualified to handle brain injury lawsuits. A qualified brain injury attorney knows the true cost of your injury over a lifetime. The attorney will not tempt you with what seems like a lucrative settlement like many “settlement mills” do.At Dolman Law Group Accident Injury Lawyers, PA, our brain injury lawyers are willing to fight relentlessly to gain the money you truly deserve — even if it means waging a court battle on your behalf. If you or someone you care about received 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. Call our office at (727) 451-6900 or fill out a 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 represented over 11,000 injury victims and has served as lead counsel in over 1000 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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