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What is the difference between coup and contrecoup brain injuries?


Due to minor falls and head impacts, an estimated 1.7 million people a year suffer from a TBI (traumatic brain injury) according to the Brain Injury Association of Louisiana. Unfortunately, some of these victims aren’t even aware of the damage until it is too late.

Coup vs. Contrecoup

TBI injuries can manifest in hundreds of different ways; some are easily diagnosable, while others are harder to recognize. The three main types of external force TBIs, coup, contre, and contrecoup injuries, affect different parts of the brain, and can be easily misdiagnosed. The following is an overview:

  • Coup injuries. Coup injuries affect the brain directly under the site of impact and are therefore the most identifiable type of traumatic brain injuries. When the head hits a surface, the force of the impact can cause contusions, cuts, indentations, and bruising. If severe enough, these injuries can cause hemorrhaging, bruising, cuts, and swelling to not only the skull—but also the brain itself. 
  • Contrecoup injuries. Contrecoup injuries are harder to identify, because they affect the opposite side of the brain to where the impact initially took place. In these situations, the force of a blow actually causes the brain to shift and forcefully collide into the opposite side of the skull. This collision can also lead to bleeding, bruising, cuts, hemorrhaging and swelling. These injuries are harder to initially identify, thus making them more dangerous for long-term risks.  
  • Coup-Contrecoup injuries. Coup-contrecoup injuries are sustained when a single injury causes internal damage to both the site of impact, as well as the opposite side of the brain. These types of injuries can be the most severe, due not only to the fact that both sides of the brain have been affected, but also due to the prevalence of misdiagnoses. In many cases, either the coup or the contre injuries are identified, but diagnosing both of them at the same time can be easily overlooked, increasing your risks of permanent damage.


Head injuries—even minor ones—can cause devastating effects to your brain and shouldn’t be arbitrarily dismissed. When you accidentally bump, smack, or crack your head on something, don’t attempt to just shake it off, seek a medical opinion immediately. You never know what circumstances could lead to permanent and irreversible brain damage.

Has an accident left you, or a loved one with a catastrophic brain injury? Don’t allow someone else’s mistake to affect the rest of your life. Contact us today for a free consultation and evaluation of your injury claim. We know how devastating a TBI can be to you and your family, but you don’t have to go through it alone. Call now to get the support and justice you deserve.

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