Coup-Contrecoup

Background

  • Type of TBI
  • Coup: injury site on the side of the blunt force mechanism
  • Contrecoup: opposing side injury from movement of the brain and cerebral spinal fluid shift from translational forces

Clinical Features

  • TBI like symptoms
  • Headache
  • Visionary discomfort
  • Nausea and Vomiting
  • Dizziness
  • Fatigue
  • Uneven gait

Differential Diagnosis

Intracranial Hemorrhage

Evaluation

Labs and Imaging

  • ETOH level
  • Drug Use
  • Trauma Labs depending on history (or lack there of)

Management

  • Assess for additional injuries
  • Pain Control
  • Neurosurgery Consult
  • Trauma Consult

Disposition

  • Often kept for observation
  • Home if at baseline, no additional injuries
    • Inform about post-concussive symptoms
  • Outpatient Concussion Clinic/Head Trauma Clinic

Also See