Archive : Article / Volume 3, Issue 1
- CLINICAL IMAGES | DOI:
- https://doi.org/10.58489/2836-5127/020
Coup-Contrecoup Brain Injury: Clinical Images
1Department of Radiology, Al-Namas General Hospital, Ministry of Health, Al-Namas City-62596, Saudi Arabia
Abdulwahab F. Alahmar, Department of Radiology, Al-Namas General Hospital, Ministry of Health, Al- Namas City-62596, Saudi Arabia
Abdulwahab F. Alahmar. Coup-Contrecoup Brain Injury: Clinical Images. Radiol. Res. Diagno Imag. Vol. 3 Iss. 1 (2024). DOI: 10.58489/2836- 5127/020
© 2024 Abdulwahab F. Alahmar, this is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
- Received Date: 23-05-2024
- Accepted Date: 01-06-2024
- Published Date: 04-06-2024
Abstract
Coup-Contrecoup Brain Injury is when a part of the brain is injured and the opposite part of the brain deaccelerates and hits the inner table of the skull see (Fig. 1). This is a case of a Coup-Contrecoup Brain Injury in a 17-year-old male patient. The trauma targeted the right frontal lobe and the left parietal lobe was affected by the trauma see (Figs. 2 and 3). The patient was unstable and shifted to a tertiary hospital. Coup-contrecoup brain injuries were studied in two Indian studies [1- 2], one for 74 patients over the course of one year. The other paper studied 298 patients over a 2-year period. The first study showed that contrecoup contusion leads to a poor prognosis [1]. The second study showed that there is a difference in mortality between coup-contrecoup injuries and contrecoup injuries [2].
Figure 1: An illustration of coup-contrecoup mechanism.
Figure 2: An axial brain CT shows bilateral Crescentic shape extra-axial blood densities are seen smeared all over both hemispheres subdural in location being more on the right side, they exert mass effect manifested by effacement of the underlying cortical sulci. Measuring (10x1 cm) on left side and measuring (4x0.5 cm) on right side. Notice the arachnoid granulation thinning the skull on the right side which is an anatomical variant.
Figure 3: An axial MRI T1 shows bilateral (More left sided) frontoparietal convexity mild subdural hematoma. It appears of intermediate signal at T1 and predominantly bright signal at T2 and FLAIR with some hypointense /signal void streaks seen within. Maximal thick- ness at the right side is up to 6-7mm and at the left side is up to 11-12mm. Trans midline slight shift of about 3 mm to the right side. MRI features are that of (hyperacute) to (acute) stage.
References
- Bhateja, Arvind, Dhaval Shukla, B. Indira Devi, and VR Sastry Kolluri. “Coup and contrecoup head injuries: Predictors of out- come.” Indian Journal of Neurotrauma 6, no. 02 (2009): 115- 118.
- Alahmari, Abdulwahab F. “Coup-Contrecoup Brain Injury: Clin- ical Images.” Imaging 3 (2024): 1.
