The contrecoup-coup phenomenon
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
A common observation in closed head injuries is the contrecoup brain injury. As the in vivo brain is less dense than the cerebrospinal fluid (CSF), one hypothesis explaining this observation is that upon skull impact, the denser CSF moves toward the site of skull impact displacing the brain in the opposite direction, such that the initial impact of the brain parenchyma is at the contrecoup location.
A simple model was developed consisting of a balloon filled with water of density 1.00 g/mL enclosed in a clear plastic jar containing salt water of density 1.04 g/mL, simulating the same relative densities of the CSF and brain. The initial movement of the balloon, modeling the brain, was toward the contrecoup location with subsequent movement toward the coup location.
The pattern of brain injury in which the contrecoup injury is greater than the coup injury is a result of initial movement of the brain in the contrecoup location.
During the process of closed head injury, the brain parenchyma is initially displaced away from the site of skull impact and toward the contrecoup site resulting in the more severe brain contusion.
- Knight B. Head and spinal injuries. In: Forensic Pathology. Internet, http://www2.kobe-u.ac.jp/∼yanagida/Pathology.htm.
- Vinken, PJ, Bruyn, GW, Klawans, HL (1990) Head injury, vol. 57. Elsevier, New York
- Graham, DI, Lantos, PL (2002) Greenfield’s neuropathology. Arnold, London, UK
- Dawson, SL, Hirsch, CS, Lucas, FV, Sebek, BA (1980) The contrecoup phenomenon, reappraisal of a classic problem. Hum Pathol 11: pp. 155-166
- Gurdjian, ES, Gurdjian, ES (1976) Cerebral contusions: reappraisal of the mechanism of their development. J Trauma 16: pp. 35-51 CrossRef
- Lindenberg, R Mechanical injuries of brain and meninges. In: Spitz, WU, Fisher, RS eds. (1973) Medicolegal investigation of death. Charles C. Thomas, Spingfield, IL
- Lindenberg, R Trauma of meninges and brain. In: Minckler, J eds. (1971) Pathology of the nervous system. McGraw-Hill, New York
- Lindenberg, R, Freytag, E (1960) The mechanism of cerebral contusions. Arch Path 69: pp. 440-440
- Guyton, AC, Hall, JE (2000) Textbook of medical physiology. W.B. Saunders, Philadelphia
- Holbourn, AH (1943) Mechanics of head injuries. Lancet 2: pp. 438-438 CrossRef
- Holbourn, AH (1945) The mechanics of brain injuries. Brit Med Bull 3: pp. 147-147
- Huang, HM, Lee, MC (2000) Finite element analysis of brain contusion: an indirect impact study. Med Biol Eng Comput 38: pp. 253-259 CrossRef
- Halliday, D, Resnick, R (1970) Fundamentals of physics. John Wiley and Sons, New York
- Gurdjian, ES, Lissner, HR, Patrick, LM (1962) Protection of the head and neck in sports. JAMA 182: pp. 509-509
- Gurdjian, ES, Hogdson, VR, Thomas, LM, Patrick, LM (1968) Impact head injury—mechanisms and prevention. GP 37: pp. 78-87
- The contrecoup-coup phenomenon
Volume 1, Issue 3 , pp 385-390
- Cover Date
- Print ISSN
- Online ISSN
- Humana Press
- Additional Links
- traumatic brain injury
- contrecoup lesion
- Industry Sectors