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A “coup" injury is located at the exact site of the impact. For instance if you slam your head against the steering column immediately following a car collision, it is very possible that you may in fact suffer a coup injury at the spot of your forehead that impacts the steering column. In contrast, a “contrecoup" injury may occur at the opposite side of the brain. Where the “coup" injury occurred.

Why does this happen?

The brain has the consistency of pudding, In a high speed auto collision, the brain itself often continues moving after the head stops by impacting a stationary object or in a similar mechanism as whiplash (i.e. think of shaking baby syndrome). In acceleration/deceleration incidents where the skull does not actually impact an object, it is believed that the brain may bounce off of the skull and hit the opposite side. This often results in coup/contrecoup injuries.

Coup contrecoup injuries are generally linked closely to diffuse axonal injury

Within the brain there are countless nerve calls located within the gray matter which communicate with communicate with other distant nerve cells through nerve fibers known as axons.

During an acceleration/deceleration incident (whiplash), the head is often thrown around in a rapid violent manner. As a result, the delicate axonal fibers can twist, stretch and even tear. Many automobile accident victims, who suffer mild to moderate closedhead injuries, will present with cognitive deficit that will manifest in being easily distracted or confused and will experience difficulty with attention and concentration. Further, such individuals will encounter problems with higher level thinking (known as “executive functions") involved in organizing, planning, problem solving, abstract thinking, and making judgments. This results in an inability to successfully continue employment in his/her pre-injury occupation.

Most diffuse axonal injury victims will manifest with psychiatric issues, such as the inability to cope, depression, irritability, apathy, anxiety, frustration, insomnia and mood swings.

If you would like more information on diffuse axonal injuries, coup contrecoup injuries, or a legal issue related to a brain injury/closed head injury, simply send me an email at:

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