Cranial CT in the Evaluation of Coup and Countercoup Head Injuries

Objective: To describe the role of Cranial Computed Tomography (CT) in the evaluation of Coup and Countercoup head injuries with its outcome. Study Design: A comparative crosssectional study. Settings: Radiology Department of PMC/Allied Hospital Faisalabad. Duration: 09 months, October 2012 to June 2013. Sample Size: 150 patients. Materials and Methods: The patients with coup and countercoup head injuries were studied and divided into two groups: Coup injuries (n=117), countercoup injuries (n =33) .The groups were comparable with respect to age, Glasgow Coma Scale (GCS) and outcome. Site of primary impact was determined by CT scan pattern. Results: The mortality rates in each group were compared with respect to age, GCS and CT pattern. Significance was calculated using ChiSquare test. There was a statistically significant difference in mortality between patients with coup injuries (p≤0.005) and patients with countercoup (p≤0.001). Mortality in patients aged less than 60 years and patients with GCS <8 was significantly lower in patients with countercoup. Conclusion: Presence of a countercoup component on CT scan may show a worse outcome in head injuries and may warrant closer monitoring and more aggressive management of these patients. Keywords: Coup, Countercoup, Glasgow Coma Scale, Head Injury.