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  • Writer's pictureRobert Schuerger II

What Is a Contrecoup Injury, and How Are They Caused?

Suffering a brain injury can be life-changing. The human brain is a fascinating but fragile thing, and trauma can threaten everything about a person's way of life.


Unfortunately, brain injuries are one of the most common traumas seen in serious car accidents- which happen every single day in the US- and account for around 30% of all injury-related deaths in America.


No brain injury is considered minor. Even a light bump can lead to complications and require medical attention. Of the many types of TBI out there, the coup and contrecoup categories are often overlooked.


This guide to contrecoup injuries explains what they are, how they happen, and what impact they may have on victims. It also looks at similar injury classes that are often confused with contrecoup trauma and the important differences.


Lastly, it provides a guide for injured victims suffering from the side effects of a traumatic injury on how to claim the compensation they are rightfully owed for their pain and suffering.


Anyone with a personal injury claim for a brain injury in Ohio should contact Schuerger Schunnarah today to discuss their case and begin their journey to justice.


What Is a Contrecoup Injury?

What Is a Contrecoup Injury?


A contrecoup injury is a brain injury where the brain is damaged on the opposite side from where the trauma occurred. If the head is hit on the left side, then the injury is on the right- or if the trauma happens at the forehead, then the injury is at the back of the brain.


How Are Contrecoup Injuries Caused?


Contrecoup injuries are more likely to occur when the head hits an object- rather than being hit by something. In other words, people are more likely to suffer a contrecoup injury if their head is moving when the trauma happens.


This is because of the motion of the brain inside the skull when it suffers a blow. When a moving head is thrown suddenly after an impact, the brain moves slower than the skull. With enough force from the correct angle, the brain can collide against the opposite point of the skull before the trauma even happens.


The best example is when a driver's head is thrown backward into the headrest. Their brain could hit against the front of their skull during the movement, even though the impact was to the back of their head.


Common Causes of Contrecoup Brain Injuries

As mentioned, contrecoup brain injuries occur when the head collides with something that is not moving. Some of the most common causes of this type of head trauma include:


  • Rear-end car accidents

  • Side-impact motor vehicle accidents

  • Sudden slips, trips, and falls


Any incident where a person's head is thrown one way quickly could result in a contrecoup injury.


Diffuse Axonal Injury and Contrecoup Brain Injuries

A diffuse axonal injury (DAI) causes severe damage to the brain due to hemorrhages and often causes a permanent vegetative state to those who sustain one. While this is not directly associated with a contrecoup injury, it can happen in rare cases where the trauma involves extreme acceleration and deceleration forces or rotation.


It is more likely to occur after coup contrecoup injuries (see below).


Treatment Options for Contrecoup Injuries


The treatment plan given to a contrecoup injury patient depends on the severity of the trauma and the immediate results of a scan. A CT scan is usually the first step in any head injury case where any sort of brain trauma is suspected.


An exception would be in severe cases where immediate decompression surgery is required. The scan may be taken after this emergency procedure is performed.


From there, some patients will require surgery, and others may be treated with close monitoring. This type of head injury is usually combined with other injuries to the body- and even other brain injuries- so the treatment plan will vary based on the overall scope of a person's situation.


Management of a contrecoup injury may involve various medications and rehabilitation exercises. Again, it depends on the extent of the injuries and what other brain trauma is present.


Are the Effects of a Contrecoup Injury Permanent?


It is difficult to pinpoint permanence in contrecoup injury cases because of the many variables. A big part of the prognosis depends on the part of the brain that is injured- and what other brain trauma was sustained during the incident.


In theory, if someone were to suffer a contrecoup injury on its own without any other brain complications, the outcome is likely to be less severe than other types of traumatic brain injuries. That said, it is very rare for someone to have a contrecoup injury without any other brain trauma.


Because of this statistic, the likelihood is that people who suffer a traumatic brain injury- including a contrecoup trauma- are likely to have some long-lasting effects. Of course, these vary significantly between patients depending on force, trauma location, age, and other injuries.


Understanding Coup Contrecoup Injuries


A contrecoup injury on its own is not very common. In most cases, you hear the term coup contrecoup instead. It can be complex to understand the differences and what the terms mean, but it helps to look at each one individually.


Coup vs. Contrecoup Traumatic Brain Injury

The words coup and contrecoup come from French, meaning blow and counter blow, respectively. This provides a helpful insight into what types of injuries they are.

A coup injury is a blow to the head that results in a brain injury at the site of impact- for example, a person is hit on the left side of the skull, and the trauma is on the left side of the brain.



Coup injuries are predominantly associated with blunt force trauma. They usually occur when a moving object collides with a stationary head.


As explained above, the opposite is true for a contrecoup injury- which usually involves a moving head and puts the brain trauma directly across from the site of impact.


Sometimes, a coup injury occurs when the head hits an object, but usually in low-speed collisions with less force. The best example is in a low-speed rear-end collision when the driver hits their head on the steering wheel.


What Is a Coup Contrecoup Brain Injury?


Sometimes, the brain can be injured at both trauma site and elsewhere. When a person is involved in an accident that throws their head around violently, they could end up with a coup injury and a contrecoup injury.


A coup contrecoup injury describes an incident where a person hits their head with so much force that the brain hits the skull at the impact point hard enough to then rebound and hit it again at the other side.


What Causes Coup Contrecoup Brain Injuries?

Coup contrecoup brain injuries can happen in various situations. They happen most often when the head is thrown forward or backward with great force- hitting an object in the process. Victims of a blunt impact injury rarely have this type of diagnosis, but car accident victims do.


  • High-speed car accidents

  • Rollover car accidents

  • Sports injuries where two players collide at high speeds

  • Single-vehicle motor accidents where drivers hit a wall, pole, or other stationary obstacle


What Are the Impacts of a Coup Contrecoup Injury?

The results of a coup contrecoup injury vary from headaches to paralysis. More common symptoms include memory loss, reduced motor function, speech problems, and changes to sensory perception (taste, smell, touch, etc.). In severe cases, a coup contrecoup injury victim can become comatose- and it may even prove fatal after time.


It is not always possible to understand the full extent of the results from a coup, contrecoup, or coup contrecoup injury at first, as certain symptoms can take time to show up on scans and imaging. However, medical experts in the brain trauma field can generally give a rough prognosis based on the initial symptoms just after the accident happens.


There are also the mental impacts to consider. As well as potential physical difficulties relating to brain damage, victims may face extreme mental anguish, depression, anxiety, and other mental health issues.


Are Coup Contrecoup Injuries More Serious than Contrecoup Injuries?

Yes, they are. A coup contrecoup brain injury is more dangerous because multiple areas of the brain suffer trauma. Coup contrecoup injuries occur predominantly in high-speed, high-force accidents, so the effects can often be catastrophic.


Those who survive this type of severe head trauma may face intense recovery rehabilitation and may have life-long disabilities or challenges to deal with.


Filing a Contrecoup Head Injury Claim in Ohio

Filing a Contrecoup Head Injury Claim in Ohio


Victims of negligence that leads to head trauma- such as coup and contrecoup injuries- may be able to claim compensation for damages. Suffering a severe traumatic brain injury can lead to expensive medical treatment, long-term changes to lifestyle and quality of life, and a major impact on a person's ability to work.


The law provides an opportunity for victims and their loved ones to hold negligent parties accountable for their actions and responsible for the financial and emotional burdens caused.


Who Can Claim for Damages After a Traumatic Brain Injury?

A person who suffers a coup contrecoup injury because of someone else's actions (or inactions) could have a valid personal injury claim. It is important to be able to show a duty of care, negligence in that duty, and direct causation linking the breached duty of care to the injury.


Examples may include a driver of a vehicle that hit the victim while speeding or driving under the influence- or serious slips and falls from a height.


Family members of severely injured or deceased victims can also claim on their behalf- either through a personal injury case or wrongful death lawsuit.


How Do Coup Contrecoup Injury Claims Work?

The first step in any legal claim for traumatic brain injuries- like any other injuries- is to gather evidence, approach a personal injury lawyer in Toledo OH, and put together the case. It should include the police report or any other relevant accident report, medical records, witness statements, photographs, expert testimony, receipts, and anything else to back the claim.


All this evidence goes into a settlement demand letter- which is sent to the at-fault party's insurance company. This is the first step in settlement negotiations between the insurance company and the victim's legal counsel. If a settlement amount is agreed upon between both parties, the victim is paid compensation from the insurance company, and the case ends without going to trial. That said, incidents that involve a criminal element may also have a criminal trial. The two are separate.


When a settlement can't be reached, the victim can file a lawsuit- at which point the case is taken to trial, and a judge makes the final decision on how much compensation is owed.


Avoiding a trial is usually the best option for everyone, but it is not always possible in serious cases that involve severe traumatic brain injuries. Trial is also the only option when the defendant denies responsibility and refuses to pay damages.


What Can be Included In the Claim?

Personal injury settlement claims cover the compensatory damages owed. This means money paid to the victim by the at-fault party to repay them for losses of some kind. From there, damages are divided into two categories.


Economic Damages

Economic damages refer to any expense with a dollar value that came about because of the injury. Someone suffering from a coup contrecoup injury is likely to have hefty medical bills and lost wages, among other things.


Other possible expenses that may be covered by economic damages following a contrecoup injury include:


  • Property damage

  • Out-of-pocket expenses for traveling to and from hospital appointments

  • The long-term cost of therapy and rehabilitation

  • Purchase or rental of specialist equipment to aid in recovery

  • Cost of additional help in the home

  • Lost income during recovery

  • Legal expenses


Non-Economic Damages

A severe injury to the brain usually costs victims a lot more than money. When it is not fatal, it can leave life-long difficulties and complications- not to mention the mental trauma that goes along with a serious accident.


Non-economic damages aim to compensate victims for the things that don't come with a price tag. The extent of the injury and the long-term impact it will have on the injured person and their loved ones determines how much to award in non-economic damages.


Some of the considerations include:


  • The pain and suffering caused by the incident and injury

  • Mental anguish and emotional distress

  • Reduced quality of life

  • Permanent disabilities

  • Loss of support for dependents

  • Lost future earning capacity

  • Loss of companionship

  • Wrongful death


What Are Punitive Damages in a Contrecoup Injury Case?

Punitive damages are not part of a settlement claim. They only apply to cases taken to trial. Only a judge can award punitive damages. Instead of awarding money to compensate the victim, punitive damages are designed to punish the defendant. They generally apply when there is blatant recklessness, negligence, or criminal action that caused or contributed to the traumatic brain injury suffered by another.


Car accident lawsuits involving drunk or reckless driving usually lead to punitive damages- as do cases where wrongful death or permanent and total disability is the result of the injury. They can also help with the catastrophic injury legal definition.


How Can an Experienced Personal Injury Lawyer Help?

A coup-contrecoup injury is serious. Recovery is often a long road, and dealing with an injury claim at the same time can be a lot to handle. An experienced personal injury lawyer who specializes in brain injury cases can help navigate the waters of settlement negotiations, lawsuits, and trials.


Attorneys act on behalf of victims and their families to gather evidence, speak with witnesses and experts, and put together a strong case to take against the negligent party. They fend off attempts by the liable insurance company to low-ball victims with insufficient settlement offers- protecting those in medical recovery from being taken advantage of in an attempt to save money.


Put simply, having an experienced brain injury attorney fighting on their behalf increases victims' chances of getting the compensation they deserve- and makes the complex process of settlement negotiations much smoother and more manageable.


Schuerger Schunnarah Trial Attorneys Go to War for Tol Brain Injury Victims


Anyone who has suffered a traumatic brain injury in Ohio can count on the team at Schuerger Schunnarah to go to war for them. Victims and their loved ones can rely on these passionate and dedicated legal experts to fight for justice and fair compensation for the pain, suffering, and other damages caused.


A contrecoup injury can take years to recover from- if recovery is even possible at all. Allowing negligence to go unanswered is not an option at Schuerger Schunnarah. Contact the team today to arrange a free consultation to discuss a coup contrecoup injury suffered by you or a family member. Team up with relentless attorneys who care about individuals and go to war for Tol.

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