Your brain is cushioned by spinal fluid which acts as a buffer between your brain and your skull. When you sustain a blow to the head, the impact causes your brain to move. If the impact is severe enough, your brain may hit your skull at the site of the initial impact, and then rebound hitting the opposite end. Coup, Contrecoup, or Coup-contrecoup refers to three brain injuries where the brain comes into contact with the skull. 

The term Coup/Contrecoup describes the location of the bruising and damage that occurs when the brain comes in contact with the skull. This damage usually occurs on the frontal lobe (forehead area) or the temporal lobes (temples). However, you may not notice any external injuries. Therefore, you should seek immediate medical attention, especially in the case of a car accident. 

Furthermore, blows to the head may cause a portion of the skull to break off into the brain, or can result in extra pressure being put on the nerves of the brain. These injuries can result in problems with decision making, speaking, comprehension of language, impaired concentration, memory loss, difficulty swallowing, loss of balance and coordination, muscle weakness, and paralysis. Additionally, the force that causes these injuries may result in the expulsion of the eyes from the head. 

These injuries may also lead to several neurological problems, depending upon the area of the brain that the damage occurred. Some of which may be permanent. 

Coup vs Contrecoup vs Coup-contrecoup

The terms Coup, Contrecoup, and Coup-contrecoup demonstrate a type of head injury and reflect where the injury occurred. A coup is an injury to the brain that occurs at the site of blunt force trauma to the head. Upon impact, the portion of the brain closest to the point of impact may sustain damage if it moves enough to come into contact with the skull. 

After the initial impact, the brain may continue on in motion with the skull, headed away from the impact. However, the skull may discontinue motion, while the brain continues, causing the brain and skull to collide. This injury is contrecoup. 

A coup injury is damage to the brain at the impact site, while a contrecoup describes the damage on the opposite side of the impact.

 Coup-contrecoup demonstrates that the injury occurred on both ends of the brain. Further, coup-contrecoup can cause hematomas, a condition where the brain bleeds and swells, hematomas can interrupt the circulation of cerebrospinal fluid around the brain.


The symptoms associated with this injury may not appear for several weeks.

Symptoms include:

  • Pain in the Head
  • Vomiting
  • Blurred Vision
  • Impaired Speech
  • Confusion

If you are the recipient of blunt force trauma, you should seek immediate medical attention. 

Contrecoup Concussion 

When you sustain a coup or contrecoup injury you also sustain damage to the blood vessels and nerves of the brain. Together, these can form a concussion.

Concussions, though not necessarily life-threatening, can still be painful and disrupt your life. When you sustain a concussion, your brain will not function normally. You may experience vision loss, nausea, loss of balance, confusion, and loss of consciousness. 


It can be hard to diagnose coup/contrecoup injuries, as they often appear with several other conditions. However, if you sustain a traumatic head injury, you should seek immediate medical attention. You will need to receive a thorough medical examination, and should also get a CT or MRI image. These detailed images will help doctors properly assess your injuries.


Treatment consists mostly of time and prevention methods. You should seek medical treatment immediately after sustaining any kind of head injury, so doctors can prevent further damage.

Depending upon the severity of the injury, you may receive medications to reduce your symptoms. If necessary, doctors may perform neurosurgery in order to decrease the swelling, and/or bleeding, of the brain.

You may undergo several MRI or CT scans, for the purpose of tracking your recovery, and also the damage to your brain. 

Are you experiencing any of these symptoms? If so, please call us now at 801-683-1948 to schedule a no-cost medical exam.

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