Cranial CT in the Evaluation of Coup and Countercoup Head Injuries

Anjum Mehdi; Amir Hayat Mahais; Iqbal Hussain Dogar; Altaf Pervez Qasim

doi:10.29054/apmc/2013.390

Anjum Mehdi Associate Professor Diagnostic Radiology PMC/Allied Hospital Faisalabad, Pakistan
Amir Hayat Mahais Registrar Radiology Allied Hospital Faisalabad
Iqbal Hussain Dogar Assistant Professor Paeds Radiology King Edward Medical University Lahore
Altaf Pervez Qasim Assistant Professor of Forensic Medicine PMC/Allied Hospital Faisalabad

DOI: https://doi.org/10.29054/apmc/2013.390

Keywords: Coup, Countercoup, Glasgow Coma Scale, Head Injury

Abstract

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 cross-sectional 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 Chi-Square 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.