Which statement correctly describes coup and contrecoup together in the context of brain injury?

• A. Coup is injury directly below the impact; contrecoup is opposite side; both are associated with brain injuries
• B. Coup is opposite side; contrecoup is below the impact
• C. Coup and contrecoup are both only injuries to the brainstem
• D. Coup and contrecoup relate to spinal injuries

Answer: (A)

In coup-contrecoup injuries, the brain hits the skull at the site of impact (coup) and, due to momentum, rebounds and strikes the opposite side (contrecoup). This explains why a person can have contusions on the side of the brain directly under the impact as well as on the opposite side from the rebound. It’s a pattern seen with rapid acceleration–deceleration forces and involves brain tissue (often cortex) rather than the brainstem or spinal structures. So describing coup as injury directly beneath the impact and contrecoup as on the opposite side, with both being brain injuries, correctly captures how this phenomenon occurs.