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Coup and contrecoup brain injuries involve damage on both sides of the brain, and Regan Zambri Long’s award-winning Washington, DC traumatic brain injury lawyers understand how that internal complexity can affect neurological function, recovery, and the value of a legal claim. We front all case costs and work alongside leading medical and technical experts to clearly establish the scope of brain damage and its long-term consequences. That disciplined approach is reflected in more than 100 5 star Google reviews from clients who trusted us at critical moments.
Our TBI attorneys bring nearly 200 years of combined experience to complex injury litigation and have secured dozens of multimillion-dollar recoveries, including traumatic brain injury results of $20 million, $16 million, and $10.6 million. Our board-certified partners are recognized among the 500 Leading Plaintiff Consumer Attorneys in the United States, a distinction earned through sustained results in high-stakes cases.
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Coup damage happens when brain contusions are beneath the trauma area. A contrecoup injury occurs in the opposite location of the trauma. A coup-contrecoup head injury involves contusions just below and directly opposite the source of trauma.
A coup (pronounced like “coo”) brain injury happens upon the forceful impact of the head, like in a car crash or a fall. It’s like a bruise or damage to the brain right where the impact occurs.
Imagine you’re in a car accident, and your head hits the steering wheel. In this situation, a coup injury occurs at the front of your brain, where your forehead hits the steering wheel. It’s like when you bump your knee, and it swells up – except it’s a severe injury happening inside your head.
When your head suddenly stops due to the impact, your brain keeps moving and can slam into the inside of your skull, causing damage at the point of impact. This damage might involve bruising, bleeding, or swelling of the brain tissue.
A contrecoup (pronounced like “contra-coo”) brain injury occurs when your head is suddenly jolted, causing your brain to hit the opposite side of your skull. It’s like when you bounce back after hitting something. Your brain is surrounded by cerebrospinal fluid, which usually acts as a cushion, but when your head moves suddenly, your brain can slam into the opposite side of your skull.
For example, if you fall backward and hit the back of your head on the ground, your brain might bounce forward and hit the front of your skull. This can damage the brain tissue on the front side, even though the impact initially occurred at the back.
Contrecoup injuries can result in bruising, bleeding, or swelling of the brain tissue, just like coup injuries.
Coup-Contrecoup brain injuries are a combination of coup and contrecoup brain injuries.
Your skull is like a hard shell that encases your brain, which has a soft gel-like consistency. When you experience a forceful impact, say from a fall or a collision, your brain doesn’t just absorb the blow where it’s hit. It also slams against the opposite side of your skull, causing damage. The “coup” part refers to severe damage at the initial impact site, where the brain is first injured. The “contrecoup” is the additional damage on the opposite side of the brain due to the rebound effect inside the skull.
Coup-contrecoup brain trauma and injuries most commonly occur due to sudden, forceful impacts or rapid deceleration/acceleration of the head. Common causes of these traumatic brain injuries include:
In each of these scenarios, the sudden and forceful head motion can cause the brain to move within the skull, resulting in injuries at the impact site (coup) and the opposite side of the brain (contrecoup).
Coup-contrecoup brain injuries differ from other head injuries in the way they affect the brain. In a coup-contrecoup injury, the brain sustains damage at the point of impact and on the opposite side due to a rebound effect within the skull. For instance, if someone is hit on the forehead, the brain may also be injured at the back of the head as it rebounds against the skull.
Conversely, other head injuries usually only affect the specific area of the human brain from where the head was hit. For example, if someone falls and hits their head on the ground, the injury is typically confined to the site of impact without additional damage to the opposite side of the brain.
In a car accident, head injuries can vary as follows:
In a slip-and-fall accident, head injuries can occur in different ways, as follows:
According to the International Brain Injury Association, in the United States annually:
One million Americans are treated and released from hospital emergency departments as a result of traumatic brain injury (TBI); 230,000 people are hospitalized and survive; 80,000 people are estimated to be discharged from the hospital with some TBI-related disability; and 50,000 people die.
More recent data suggest that the overall impact of traumatic brain injuries is significantly greater than earlier estimates alone indicated. In 2023, 68,665 deaths in the United States were attributed to traumatic brain injury, pointing to a markedly higher level of fatal outcomes than reflected in older national figures. Broader measures of incidence also reinforce this trend. The Brain Injury Association of America reports that roughly 2.9 million emergency department visits each year are tied to TBIs, highlighting how frequently these injuries require urgent medical care. Beyond hospital-based data, newer population-level research paints an even wider picture, with a 2025 study finding that nearly 10 million Americans experienced a traumatic brain injury in the past year, including 3.3% of all adults and 2.2% of all children.
Life after a coup-contrecoup brain injury can involve many challenges. The long-term effects of such injuries extend far beyond the initial impact, often altering various aspects of daily life. From memory problems to emotional changes to physical weaknesses, individuals experiencing these effects face many challenges that can significantly impact their quality of life. These long-term effects aren’t just inconveniences but life-altering hurdles that can seriously alter your world.
By way of further explanation:
Living with these effects can significantly impact your quality of life, requiring patience, support, and sometimes professional assistance to manage symptoms effectively and regain a sense of normalcy.
‘These forms of compensation aim to help alleviate the financial burden and hardships caused by the injury, allowing you to focus on your recovery and rebuilding your life after such a significant event.
Suppose you or a loved one has suffered a coup-contrecoup injury due to an accident or negligence. In that case, seeking legal representation is essential to ensure you receive the compensation you deserve. With a skilled and experienced brain injury lawyer, you can pursue justice and compensation for your damages. That’s where Regan Zambri Long comes in.
Our law firm has a strong track record of success in personal injury cases, including coup-contrecoup injuries. Our dedicated attorneys understand the intricacies of these cases and work tirelessly to advocate for our clients’ rights. With our expertise and commitment to justice, you can trust Regan Zambri Long to fight for your deserved compensation.
All three of our founding partners are board-certified in Civil Trial Law and Civil Trial Advocacy by the National Board of Trial Advocacy, and each is AV Preeminent rated by Martindale-Hubbell, placing them within the top 10% of attorneys nationwide based on peer review.
Our trial experience is also recognized nationally. All six partners are named to Lawdragon’s 500 Leading Plaintiff Consumer Lawyers. Locally, Salvatore Zambri, Paul Cornoni, and Patrick Regan have been named among the Top 100 Super Lawyers in Washington, DC, a distinction drawn from a legal community of roughly 80,000 attorneys in the District.
Several of our partners are also fellows of invitation-only trial organizations whose membership represents less than one-half of 1% of American lawyers, including the International Academy of Trial Lawyers, the American Board of Trial Advocates, and the International Society of Barristers. That level of peer selection reflects sustained experience handling cases where the medical science, causation, and long-term consequences are heavily contested.
Our work in coup-contrecoup injury cases is grounded in results. Over the last three decades, we have secured more than $1 billion in personal injury recoveries, with many multi-million dollar TBI settlements and verdicts.
Contact Regan Zambri Long today to schedule a consultation and take the first step towards securing the compensation and closure you need to move forward with your life.
Have you or your loved one sustained injuries in Washington DC, Maryland or Virginia? Regan Zambri Long PLLC has the best lawyers in the country to analyze your case and answer the questions you may have.