Coup-Contrecoup Injury Case Study

It was September 30th, 2004. Former Pittsburgh Steeler Justin Strzelczyk drove his Ford pickup drunk the wrong way across highway I-90 colliding head-on with a tanker truck and died on impact (Finder). Justin wasn’t on drugs or drinking(Finder). Justin had a bipolar disorder from concussions from when he played football (Finder). According to WebMD “The brain is made of soft tissue. It's cushioned by spinal fluid and encased in the protective shell of the skull. When you sustain a concussion, the impact can jolt your brain. Sometimes, it literally causes it to move around in your head. Traumatic brain injuries can cause bruising, damage to the blood vessels, and injury to the nerves” (Lava). In a short and sweet version; it is a bruise to the brain. Concussions also have different levels

In order to understand the origin of concussions, one must first understand how the head is affected by contact forces. When the head strikes or is struck by an object, both contact and inertial forces are applied to head (Meaney). These forces can cause injury to the brain both in close proximity to the impact zone or at more distant points. Focal forces are related to head injuries such as skull fractures and can cause stress waves that cause fractures at a distance from the impact zone where the skull has reduces structural properties. The primary cause of concussive injuries is large acceleration of the brain due to inertial forces. Due to how the head moves, the head undergoes both linear and rotational acceleration during impact. It has been found that linear accelerations correspond to increased pressure within the brain. This increased pressures causes neurologic dysfunction. The rotational acceleration component of impact is caused by rapid head rotations. These accelerations create shear forces in the brain . Further studies have shown that brain tissue deforms more severely in response to shear forces (Arash). Shear deformation caused by rotational acceleration is widely accepted as the primary mechanism in concussive injury.

Considering potential damage to the spine of a trauma victim within the overall treatment of a patient is vital when preventing any secondary injury. As stated in the ARC Guideliness,1 symptoms and signs of a spinal injury can include pain in the injured region, paralysis, nausea, headaches, dizziness, absent skin sensation, an abnormal head or neck position, an associated head injury, an altered conscious state, difficulties breathing or loss of function in limbs. Falls in the elderly population or a significant blow to the head are also commonly recognised as causing spinal damage.1 As an elderly woman with a substantial blow to the head and an altered state of consciousness, the patient should be treated as having a suspected

For a long time, traumatic brain injury has been a large contributor to disabilities and death within the United States. Around 30 percent of these injuries lead to death, and those who survive these injuries may suffer from short-term side effects to long-term disabilities. It can range from a minor head injury to a major injury that you might suffer from a motorcycle accident.

The leading causes of Traumatic Brain Injuries are falls, motor vehicle accidents, struck by or against objects, and assaults. The initial

understanding of how much injury occurs to the brain and nervous system during impacted car

Traumatic brain injuries can vary in their severity. In the case of mild brain injury, full recovery is possible. On the other hand, severe brain injury can be fatal or cause permanent disabilities, the type of which depend on the affected area of the brain. A head injury is usually obvious because of visible wounds to the head. However, the coup-contrecoup brain injury may occur without any exterior damage to the head or skull. The victim may first feel a headache, but because there's no evidence of a head injury, the coup-contrecoup may go undiagnosed and death may occur in a matter of hours or days.

With a Coup-Countrecoup injury, damage occurs to two sides of the brain. Assuming that Tessie’s head hit the wind shield the initial impact (coup) may have caused damage to the frontal lobe, with a second impact (contrecoup) to the opposite side of the brain the occipital lobe or cerebellum. With the brain having a semisolid form, the initial impact would causes the brain to slam into the skull, and then rebound and hit the opposite side of the skull. Research shows that often times the temporal lobe and the occipital are involved in the contrecoup injury (Taylor, Ludwigsen, & Ford, 2014). Lost consciousness and a glacoscaw score of 3 means the injury is severe. A closed injury to the brain results in swelling and effect CPP, decreasing the

Traumatic brain injury (TBI) is alterations of the brain function and brain pathology caused by an external force (LeBorgne, 2013). The two types of TBI are open and closed injuries (LeBorgne, 2013). Open injuries results from a penetration of the skull (LeBorgne, 2013). Closed injuries or no penetrating causes damage at the point of impact (LeBorgne, 2013). Closed head injuries include, but are not limited to concussion, contusion, and second impact syndrome (LeBorgne, 2013). A closed head injury involves edema, and an increase in intracranial pressure that causes further injury (LeBorgne, 2013). Between 2002 and 2006 falls were the leading cause of TBI among all age groups in the United States, followed by motor vehicular accidents, strike against an object and assaults (Powell, 2014). Falls related to the greatest amount of emergency department visits and hospitalization, compared to motor vehicular accidents that were the leading cause of death (Powell, 2014).

Traumatic Brain Injury (TBI) has continually garnered concern from the public. Effects of a TBI range from headaches to loss of motor functions in more severe cases. Normally when one hears that term, their first thought is about military personnel in a war zone. Now, that is definitely true; however, military personal are not the only ones who can receive a TBI. Anyone can suffer damage to the brain resulting in a TBI. A person’s head doesn’t even have to come into contact with another object for this to occur.

This patient most likely has a extradural (epidural) hematoma and the temporal fossa is the most common site of this type of hematoma caused by “injury to the middle meningeal artery or vein”(McCance & Huether, 2014, p. 584). “Expanding high-volume epidural hematomas can produce a midline shift and cause herniation of the brain. Compressed cerebral tissue can impinge on the third cranial nerve resulting in pupillary dilation and contralateral hemiparesis or extensor motor response”(Price, 2014, p. 3). Extradural hematomas are medical emergencies and surgical intervention is needed to remove the clot and reduce the pressure on the brain. Whether treated or untreated, this type of hematoma has an elevated risk of brain damage. However, left untreated, patients with extradural hematomas have a high risk of

Subdural Hematoma occurs when blood vessels, usually veins, rupture between the brain and outermost of the three membrane layers that protect your brain. The leaking blood forms a Hematoma. If the Hematoma keep enlarging, it will result in a decline in consciousness, possibly resulting in death. The three types of Subdural Hematoma are: Acute which happens to be the most dangerous of all three, Usually caused by a severe head injury. Subacute, signs and symptoms develop at a slower

Traumatic brain injury (TBI), or intracranial injury, is a medical diagnosis which refers to closed or penetrative damage to the brain that is caused by an external source. Every year, TBIs affect approximately 150-250 people in a population of 100,000 (León-Carrión, Domínguez-Morales, Martín, & Murillo-Cabezas, 2005). The leading causes of TBI are traffic accidents, work injuries, sports injuries, and extreme violence (León-Carrión et al., 2005). TBI is most often fatal when the cause is an injury due to the use of firearms, a traffic accident, or a long fall (León-Carrión et al., 2005). However, fatality rates and rates of occurrence differ in various countries due to

Based on the neurological exam, Mr. Hendrix injury occurred primarily in the lumbar region. The Lumbar region which is located around the lower back of the body, which is also the area where Mr. Hendrix said he first felt pain immediately following the incident. The lumbar region controls most of the lower portion of the body. Lumbar 1 -3 affected his hip flexion, Lumbar 4 inhibited Mr. Hendrix’s ability to extend his knee, and Lumbar 5 affected his ability to dorsiflex his ankle. The reason that the spinal cord effects this region is due to a bundle muscle fibers being intertwined with those sections, also known as Myotome. This injury is recognized in the medical industry as Paraplegia.

In a subarachnoid hemorrhage, bleeding occurs within the space between the brain and the skull. This type of stroke accounts for about 7% of all strokes. A subarachnoid hemorrhage is often signaled by a sudden thunderclap headache thats more severe than any you have ever felt. About half of all people who experience a subarachnoid hemorrhage die. Half of those who survive are left