Coup contrecoup injury

Source: Wikipedia, the free encyclopedia.
When the head strikes a fixed object, the coup injury occurs at the site of impact and the contrecoup injury occurs at the opposite side.

In head injury, a coup injury occurs under the site of impact with an object, and a contrecoup injury occurs on the side opposite the area that was hit.[1] Coup and contrecoup injuries are associated with cerebral contusions,[2] a type of traumatic brain injury in which the brain is bruised. Coup and contrecoup injuries can occur individually or together. When a moving object impacts the stationary head, coup injuries are typical,[3] while contrecoup injuries are produced when the moving head strikes a stationary object.[1]

Coup and contrecoup injuries are considered focal brain injuries – those that occur in a particular spot in the brain – as opposed to diffuse injuries, which occur over a more widespread area.[4] Diffuse axonal injury is the most prevalent pathology of coup contrecoup.[5]

The exact mechanism for the injuries, especially contrecoup injuries, is a subject of much debate.

skull. It is likely that inertia is involved in the injuries, e.g. when the brain keeps moving after the skull is stopped by a fixed object or when the brain remains still after the skull is accelerated by an impact with a moving object.[6] Additionally, increased intracranial pressure and movement of cerebrospinal fluid following a trauma may play a role in the injury.[6][7]

Mechanisms

Coup contrecoup injury.

Coup injury may be caused when, during an impact, the brain undergoes

tensile forces.[8] These forces directly disrupt neurons, axons, other neural and meningeal structures, and blood vessels in local or diffuse patterns, typically leading to various cellular, neurochemical and metabolic effects.[7]

Features

Contrecoup, which may occur in

hemorrhage, or subdural hematoma.[7][10]

Closed head injury (coup contrecoup) can damage more than the impact sites on the brain, as axon bundles may be torn or twisted, blood vessels may rupture, and elevated intracranial pressure can distort the walls of the ventricles.[7][10][11] Diffuse axonal injury is a key pathology in concussive brain injury.[5] The visual system may be affected.[12][13]

Contrecoup contusions are particularly common in the lower part of the

lens of the eye,[2] the lung,[14] and the skull[15]
may also result from concussion.

History

In the 17th century,

experiments on animals and recommending treatments such as bloodletting and application of herbs to patients' heads.[17]

In popular culture

  • In the Perry Mason TV series, contrecoup lacerations were used as evidence in at least two episodes, including "The Case of the Jaded Joker" (1959)[18] and "The Case of the Bluffing Blast" (1963).[19][20]
  • In "
    Hawkeye Pierce
    , M.D. diagnoses himself as having a contrecoup injury.
  • In "
    doctor
    is able to use the distinction between coup injury and contrecoup injury to determine that a dead crewman was murdered.
  • "Contrecoup" is the title of a They Might Be Giants song off their 2007 album The Else. It was written as a challenge to create a song using the words "contrecoup", "craniosophic", and "limerent", and likens an infatuation to the effects of a traumatic brain injury.[21]
  • In Stephen King's novel Duma Key, the main character has brain damage from a contrecoup injury (spelled "contracoup").
  • The distinction between coup and contrecoup injuries is described and portrayed in "Betrayal - Part 2", episode 202 of the BBC television drama series "Silent Witness" (2019).

References

  1. ^
    doi:10.1016/S1522-8401(03)00061-2
    .
  2. ^ a b Lury K, Castillo M (2004). "Lens dislocation: An unusual form of contrecoup injury". American Journal of Roentgenology. 183 (1): 250–251.
    PMID 15208154
    .
  3. PMID 9662103
    .
  4. ^
    PMID 12391630
    .
  5. ^
    PMID 22285252
    .
  6. ^ a b c Shaw NA (2002). "The neurophysiology of concussion". Progress in Neurobiology. 67 (4): 281–344.
    S2CID 46514293
    .
  7. ^
    PMID 25702209
    .
  8. PMID 17465046
    . Retrieved 2008-01-14.
  9. ^ NINDS. "Traumatic Brain Injury: Hope Through Research". National Institute of Neurological Disorders and Stroke. Archived from the original on 2016-12-18. Retrieved 2008-01-25.
  10. ^
    PMID 27855610
    .
  11. ISBN 978-0-13-431927-8
    .
  12. S2CID 14736729
    .
  13. PMID 26444405
    .
  14. S2CID 30029379.{{cite journal}}: CS1 maint: numeric names: authors list (link
    )
  15. ISBN 1-58562-105-6
    . Retrieved 2008-06-10.
  16. ISSN 0894-5799. Archived from the original
    on 2021-03-07. Retrieved 2014-08-22.
  17. OCLC 471656884
    .
  18. ^ Transcript
  19. ^ Transcript
  20. ^ Archive of "The Next Big Thing" radio, Jan. 13, 2005, Perry Mason clip played at 23:43 and 28:25.
  21. ISSN 1059-1028
    . Retrieved 2023-10-23.

External links

  • The dictionary definition of contrecoup at Wiktionary
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