fbpx
Wikipedia

Coup contrecoup injury

April 12, 2024

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]

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.

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.[6] In general, they involve an abrupt deceleration of the head, causing the brain to collide with the inside of the 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 edit

 
Coup contrecoup injury.

Coup injury may be caused when, during an impact, the brain undergoes linear acceleration and deceleration forces or rotational forces, causing it to collide with the opposite side of the skull.[7] The injuries can also be caused solely by acceleration or deceleration in the absence of an impact.[7] Contrecoup injury may be produced by 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 edit

Contrecoup, which may occur in shaken baby syndrome and vehicle accidents, can cause diffuse axonal injury.[9] In some circumstances, concussive injury can cause microvascular disruption, 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 frontal lobes and the front part of the temporal lobes.[4] Injuries that occur in body parts other than the brain, such as the lens of the eye,[2] the lung,[14] and the skull[15] may also result from concussion.

History edit

In the 17th century, Jean Louis Petit described contrecoup injuries.[16] In 1766, the French surgeon Antoine Louis coordinated a meeting of the Académie Royale de Chirurgie on contrecoup injuries, at which papers were to be presented, one of which would be chosen to receive the respected prize, the Prix de l'Académie Royale de Chirurgie. The presenter of the chosen paper was not awarded the prize because he failed to make recommended changes. In 1768, the group met again on the topic, and Louis Sebastian Saucerotte won the prize for his paper describing contrecoup injuries in humans and experiments on animals and recommending treatments such as bloodletting and application of herbs to patients' heads.[17]

In popular culture edit

  • 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", an episode of M*A*S*H, Captain Hawkeye Pierce, M.D. diagnoses himself as having a contrecoup injury.
  • In "Meld", an episode of Star Trek: Voyager, the ship's 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 edit

  1. ^ a b Poirier MP (2003). "Concussions: Assessment, management, and recommendations for return to activity". Clinical Pediatric Emergency Medicine. 4 (3): 179–185. 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. doi:10.2214/ajr.183.1.1830250. PMID 15208154.
  3. ^ Morrison AL, King TM, Korell MA, Smialek JE, Troncoso JC (1998). "Acceleration-deceleration injuries to the brain in blunt force trauma". American Journal of Forensic Medicine and Pathology. 19 (2): 109–112. doi:10.1097/00000433-199806000-00002. PMID 9662103.
  4. ^ a b Hardman JM, Manoukian A (2002). "Pathology of head trauma". Neuroimaging Clinics of North America. 12 (2): 175–187, vii. doi:10.1016/S1052-5149(02)00009-6. PMID 12391630.
  5. ^ a b Johnson, V. E; Stewart, W; Smith, D. H (2012). "Axonal Pathology in Traumatic Brain Injury". Experimental Neurology. 246: 35–43. doi:10.1016/j.expneurol.2012.01.013. PMC 3979341. PMID 22285252.
  6. ^ a b c Shaw NA (2002). "The neurophysiology of concussion". Progress in Neurobiology. 67 (4): 281–344. doi:10.1016/S0301-0082(02)00018-7. PMID 12207973. S2CID 46514293.
  7. ^ a b c d e f McKee, A. C; Daneshvar, D. H (2015). "The neuropathology of traumatic brain injury". Traumatic Brain Injury, Part I. Handbook of Clinical Neurology. Vol. 127. pp. 45–66. doi:10.1016/B978-0-444-52892-6.00004-0. ISBN 9780444528926. PMC 4694720. PMID 25702209.
  8. ^ Bernhardt DT (December 18, 2007). "Concussion". The New England Journal of Medicine. 356 (17). eMedicine.com: 1788, author reply 1789. PMID 17465046. Retrieved 2008-01-14.
  9. ^ NINDS. . National Institute of Neurological Disorders and Stroke. Archived from the original on 2016-12-18. Retrieved 2008-01-25.
  10. ^ a b Li, F; Li, H; Xiao, Z; Lu, R; Zhang, Z; Zhu, H; Ren, L (2017). "A Review on Injury Mechanism of Intracerebral Hemorrhage in Vehicle Accidents". Current Pharmaceutical Design. 23 (15): 2177–2192. doi:10.2174/1381612823666161118144829. PMID 27855610.
  11. ^ Carlson, Neil; Birkett, Melissa (2017). Physiology of Behavior. Pearson. pp. 494–495. ISBN 978-0-13-431927-8.
  12. ^ Ventura, R. E; Balcer, L. J; Galetta, S. L (2014). "The neuro-ophthalmology of head trauma". The Lancet Neurology. 13 (10): 1006–16. doi:10.1016/S1474-4422(14)70111-5. PMID 25231523. S2CID 14736729.
  13. ^ Ventura, R. E; Balcer, L. J; Galetta, S. L (2015). "The Concussion Toolbox: The Role of Vision in the Assessment of Concussion". Seminars in Neurology. 35 (5): 599–606. doi:10.1055/s-0035-1563567. PMID 26444405.
  14. ^ Oyetunji, T. A; Jackson, H. T; Obirieze, A. C; Moore, D; Branche, M. J; Greene, W. R; Cornwell Ee, 3rd; Siram, S. M (2013). "Associated injuries in traumatic sternal fractures: A review of the National Trauma Data Bank". The American Surgeon. 79 (7): 702–5. doi:10.1177/000313481307900714. PMID 23816003. S2CID 30029379.{{cite journal}}: CS1 maint: numeric names: authors list (link)
  15. ^ Gennarelli GA, Graham DI (2005). "Neuropathology". In Silver JM, McAllister TW, Yudofsky SC (eds.). Textbook Of Traumatic Brain Injury. Washington, D.C.: American Psychiatric Association. p. 29. ISBN 1-58562-105-6. Retrieved 2008-06-10.
  16. ^ Masferrer R, Masferrer M, Prendergast V, Harrington TR (2000). . BNI Quarterly. 16 (1). Barrow Neurological Institute. ISSN 0894-5799. Archived from the original on 2021-03-07. Retrieved 2014-08-22.
  17. ^ Finger S (2001). Origins of Neuroscience: A History of Explorations into Brain Function. Oxford, UK: Oxford University Press. pp. 429–430. ISBN 0-19-514694-8. 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. ^ Liu, Jonathan H. "Save the Words!". Wired. ISSN 1059-1028. Retrieved 2023-10-23.

External links edit

  •   The dictionary definition of contrecoup at Wiktionary

April 12, 2024
coup, contrecoup, injury, head, injury, coup, injury, occurs, under, site, impact, with, object, contrecoup, injury, occurs, side, opposite, area, that, coup, contrecoup, injuries, associated, with, cerebral, contusions, type, traumatic, brain, injury, which, . 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 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 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 6 In general they involve an abrupt deceleration of the head causing the brain to collide with the inside of the 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 Contents 1 Mechanisms 2 Features 3 History 4 In popular culture 5 References 6 External linksMechanisms edit nbsp Coup contrecoup injury Coup injury may be caused when during an impact the brain undergoes linear acceleration and deceleration forces or rotational forces causing it to collide with the opposite side of the skull 7 The injuries can also be caused solely by acceleration or deceleration in the absence of an impact 7 Contrecoup injury may be produced by 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 editContrecoup which may occur in shaken baby syndrome and vehicle accidents can cause diffuse axonal injury 9 In some circumstances concussive injury can cause microvascular disruption 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 frontal lobes and the front part of the temporal lobes 4 Injuries that occur in body parts other than the brain such as the lens of the eye 2 the lung 14 and the skull 15 may also result from concussion History editIn the 17th century Jean Louis Petit described contrecoup injuries 16 In 1766 the French surgeon Antoine Louis coordinated a meeting of the Academie Royale de Chirurgie on contrecoup injuries at which papers were to be presented one of which would be chosen to receive the respected prize the Prix de l Academie Royale de Chirurgie The presenter of the chosen paper was not awarded the prize because he failed to make recommended changes In 1768 the group met again on the topic and Louis Sebastian Saucerotte won the prize for his paper describing contrecoup injuries in humans and experiments on animals and recommending treatments such as bloodletting and application of herbs to patients heads 17 In popular culture editIn 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 an episode of M A S H Captain Hawkeye Pierce M D diagnoses himself as having a contrecoup injury In Meld an episode of Star Trek Voyager the ship s 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 edit a b Poirier MP 2003 Concussions Assessment management and recommendations for return to activity Clinical Pediatric Emergency Medicine 4 3 179 185 doi 10 1016 S1522 8401 03 00061 2 a b Lury K Castillo M 2004 Lens dislocation An unusual form of contrecoup injury American Journal of Roentgenology 183 1 250 251 doi 10 2214 ajr 183 1 1830250 PMID 15208154 Morrison AL King TM Korell MA Smialek JE Troncoso JC 1998 Acceleration deceleration injuries to the brain in blunt force trauma American Journal of Forensic Medicine and Pathology 19 2 109 112 doi 10 1097 00000433 199806000 00002 PMID 9662103 a b Hardman JM Manoukian A 2002 Pathology of head trauma Neuroimaging Clinics of North America 12 2 175 187 vii doi 10 1016 S1052 5149 02 00009 6 PMID 12391630 a b Johnson V E Stewart W Smith D H 2012 Axonal Pathology in Traumatic Brain Injury Experimental Neurology 246 35 43 doi 10 1016 j expneurol 2012 01 013 PMC 3979341 PMID 22285252 a b c Shaw NA 2002 The neurophysiology of concussion Progress in Neurobiology 67 4 281 344 doi 10 1016 S0301 0082 02 00018 7 PMID 12207973 S2CID 46514293 a b c d e f McKee A C Daneshvar D H 2015 The neuropathology of traumatic brain injury Traumatic Brain Injury Part I Handbook of Clinical Neurology Vol 127 pp 45 66 doi 10 1016 B978 0 444 52892 6 00004 0 ISBN 9780444528926 PMC 4694720 PMID 25702209 Bernhardt DT December 18 2007 Concussion The New England Journal of Medicine 356 17 eMedicine com 1788 author reply 1789 PMID 17465046 Retrieved 2008 01 14 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 a b Li F Li H Xiao Z Lu R Zhang Z Zhu H Ren L 2017 A Review on Injury Mechanism of Intracerebral Hemorrhage in Vehicle Accidents Current Pharmaceutical Design 23 15 2177 2192 doi 10 2174 1381612823666161118144829 PMID 27855610 Carlson Neil Birkett Melissa 2017 Physiology of Behavior Pearson pp 494 495 ISBN 978 0 13 431927 8 Ventura R E Balcer L J Galetta S L 2014 The neuro ophthalmology of head trauma The Lancet Neurology 13 10 1006 16 doi 10 1016 S1474 4422 14 70111 5 PMID 25231523 S2CID 14736729 Ventura R E Balcer L J Galetta S L 2015 The Concussion Toolbox The Role of Vision in the Assessment of Concussion Seminars in Neurology 35 5 599 606 doi 10 1055 s 0035 1563567 PMID 26444405 Oyetunji T A Jackson H T Obirieze A C Moore D Branche M J Greene W R Cornwell Ee 3rd Siram S M 2013 Associated injuries in traumatic sternal fractures A review of the National Trauma Data Bank The American Surgeon 79 7 702 5 doi 10 1177 000313481307900714 PMID 23816003 S2CID 30029379 a href Template Cite journal html title Template Cite journal cite journal a CS1 maint numeric names authors list link Gennarelli GA Graham DI 2005 Neuropathology In Silver JM McAllister TW Yudofsky SC eds Textbook Of Traumatic Brain Injury Washington D C American Psychiatric Association p 29 ISBN 1 58562 105 6 Retrieved 2008 06 10 Masferrer R Masferrer M Prendergast V Harrington TR 2000 Grading Scale for Cerebral Concussions BNI Quarterly 16 1 Barrow Neurological Institute ISSN 0894 5799 Archived from the original on 2021 03 07 Retrieved 2014 08 22 Finger S 2001 Origins of Neuroscience A History of Explorations into Brain Function Oxford UK Oxford University Press pp 429 430 ISBN 0 19 514694 8 OCLC 471656884 Transcript Transcript Archive of The Next Big Thing radio Jan 13 2005 Perry Mason clip played at 23 43 and 28 25 Liu Jonathan H Save the Words Wired ISSN 1059 1028 Retrieved 2023 10 23 External links edit nbsp The dictionary definition of contrecoup at Wiktionary Retrieved from https en wikipedia org w index php title Coup contrecoup injury amp oldid 1217612226, wikipedia, wiki, book, books, library,

article

, read, download, free, free download, mp3, video, mp4, 3gp, jpg, jpeg, gif, png, picture, music, song, movie, book, game, games.