The contrecoup-coup phenomenon - A new understanding of the mechanism of closed head injury

被引:58
作者
Drew, LB
Drew, WE
机构
[1] Oakwood High Sch, Dayton, OH 45419 USA
[2] Wright Patterson Med Ctr, Wright Patterson AFB, OH USA
关键词
biomechanics; traumatic brain injury; pathology; contrecoup lesion;
D O I
10.1385/NCC:1:3:385
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
A common observation in closed head injuries is the contrecoup brain injury. As the in vivo brain is less dense than the cerebrospinal fluid (CSF), one hypothesis explaining this observation is that upon skull impact, the denser CSF moves toward the site of skull impact displacing the brain in the opposite direction, such that the initial impact of the brain parenchyma is at the contrecoup location. A simple model was developed consisting of a balloon filled with water of density 1.00 g/mL enclosed in a clear plastic jar containing salt water of density 1.04 g/mL, simulating the same relative densities of the CSF and brain. The initial movement of the balloon, modeling the brain, was toward the contrecoup location with subsequent movement toward the coup location. The pattern of brain injury in which the contrecoup injury is greater than the coup injury is a result of initial movement of the brain in the contrecoup location. During the process of closed head injury, the brain parenchyma is initially displaced away from the site of skull impact and toward the contrecoup site resulting in the more severe brain contusion.
引用
收藏
页码:385 / 390
页数:6
相关论文
共 15 条
[1]  
[Anonymous], PATHOLOGY NERVOUS SY
[2]   THE CONTERCOUP PHENOMENON - REAPPRAISAL OF A CLASSIC PROBLEM [J].
DAWSON, SL ;
HIRSCH, CS ;
LUCAS, FV ;
SEBEK, BA .
HUMAN PATHOLOGY, 1980, 11 (02) :155-166
[3]  
Graham D.I., 2002, Greenfield's Neuropathology
[4]  
GURDJIAN ES, 1968, GEN PRACT, V37, P78
[5]   CEREBRAL CONTUSIONS - RE-EVALUATION OF MECHANISM OF THEIR DEVELOPMENT [J].
GURDJIAN, ES ;
GURDJIAN, ES .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1976, 16 (01) :35-51
[6]   PROTECTION OF HEAD AND NECK IN SPORTS [J].
GURDJIAN, ES ;
PATRICK, LM ;
LISSNER, HR .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1962, 182 (05) :509-&
[7]  
Guyton AC, 2000, Textbook of Medical Physiology, V10th
[8]  
Halliday D., 1970, FUNDAMENTALS PHYS
[9]  
Holbourn AHS, 1943, LANCET, V2, P438
[10]   THE MECHANICS OF BRAIN INJURIES [J].
HOLBOURN, AHS .
BRITISH MEDICAL BULLETIN, 1945, 3 (06) :147-149