Coup and Contrecoup Injury: Definition & Symptoms

Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

This lesson is going to define coup and contrecoup injuries from multiple perspectives. You'll also get a clear example of a common type of one and learn about some signs and symptoms of these injuries.


Can't we just call things what they are in medicine? If this lesson's title were in normal person speak, it would be called Blow & Counterblow Injury. That's because the word coup means 'blow' or 'a blow', and thus contrecoup is easier termed as 'counterblow'. That's the literal meaning of a coup and contrecoup injury.

Most often, albeit not always, this term is used with respect to traumatic brain injuries. This lesson will further define the term in this light and then go over its possible signs and symptoms.


Coup and contrecoup injury, with respect to its most common usage, implies that there has been a traumatic injury to the brain. Specifically, the injury is a contusion, or more simply a bruise. But don't be fooled! While a bruise on the skin is usually nothing, even a small bruise to the brain can be very serious.

More specifically, coup and contrecoup injuries are best generally defined as follows. The injury to the brain that occurs in the area of direct impact is the coup injury. The injury that occurs at the opposite side of impact is the contrecoup injury.

For instance, let's say that Dan goes skiing. Being like many skiers out on the mountain, he decides to forego a helmet. Not watching where he's skiing he slams into a tree, hitting his forehead on the tree. In this specific instance, the injury to the front of his brain, the frontal lobes, would be the coup injury. The injury to the back of his brain, the occipital lobes, would be the contrecoup injury.

Coup and contrecoup injury.
Coup and contrecoup injury

Signs & Symptoms

The signs and symptoms of such an injury all depend on the location of the bruise(s) and the severity of the injury. Some possible things Dan might experience include:

  • Loss of consciousness
  • Coma
  • Confusion
  • Headache
  • Seizures
  • Dizziness
  • A loss of balance and coordination
  • Fatigue
  • Nausea or vomiting
  • Memory problems
  • Mood issues, including depression, agitation, or anxiety
  • Blurred vision
  • A ringing in the ears
  • Sensitivity to light and noise
  • Slurred speech

Non-Brain Coup and Contrecoup Injuries

Before wrapping things up, it bears mentioning a small point. While coup and contrecoup injuries are most often described as part of traumatic brain injuries, the term has been applied to other parts of the body. For example, coup and contrecoup injuries have been suspected in the chest and pelvis and even specific organs like the heart after traumatic injuries, like those of car accidents.

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