{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T06:14:37Z","timestamp":1783577677164,"version":"3.55.0"},"reference-count":11,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":188,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Coup\u2013contrecoup brain injury occurs when trauma produces focal damage both at the site of impact (coup) and at the contralateral side (contrecoup) due to intracranial pressure (ICP) dynamics and rotational forces. These injuries are frequently seen in high\u2010velocity accidents and often demand staged neurosurgical intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>We report a case of a 14\u2010year\u2010old boy presenting with altered sensorium following a road traffic accident. Initial CT revealed a large left frontal extradural hematoma (EDH) with mass effect and contralateral right frontotemporoparietal contusion. He underwent emergency left frontal craniotomy and evacuation of ~150\u2009mL of EDH. Despite initial improvement, the patient developed neurological deterioration with anisocoria on postoperative day three. Repeat CT revealed worsening contralateral contusion with subdural hematoma (SDH) and midline shift. A right frontotemporoparietal decompressive craniectomy with lax duraplasty was performed, resulting in resolution of mass effect. The patient showed progressive neurological recovery, was decannulated, discharged on postoperative day 18, and later underwent elective cranioplasty with good functional outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Coup\u2013contrecoup injuries are mechanistically linked to rotational acceleration, ICP gradients, and skull deformation, rather than simple rebound forces. Frontal and temporal lobes are most commonly involved. Clinical predictors of outcome include Glasgow coma scale (GCS), pupillary reactivity, presence of SDH, and systemic secondary insults. These injuries are dynamic, with contralateral lesion progression often necessitating vigilant monitoring and timely intervention. Management requires repeat neuroimaging, control of ICP, and staged surgical procedures when indicated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/cris\/9963242","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:26:52Z","timestamp":1783574812000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dual Impact: Coup\u2013Contrecoup Brain Injury in a Young Cyclist\u2014A Case Report"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2692-9404","authenticated-orcid":false,"given":"Abhishek","family":"Kumar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0212-0175","authenticated-orcid":false,"given":"Shashikant","family":"Prasad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4193-0805","authenticated-orcid":false,"given":"Majid","family":"Anwer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5849-3958","authenticated-orcid":false,"given":"Anurag","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8271-5784","authenticated-orcid":false,"given":"Anil","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1942.01220010022002"},{"key":"e_1_2_12_2_2","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1136\/bmj.1.1846.1196","article-title":"The Mechanism of Contre-Coup and of Certain Other Forms of Intracranial Injury","volume":"1","author":"Allen F. J.","year":"1896","journal-title":"British Medical Journal"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-197601000-00005"},{"key":"e_1_2_12_4_2","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1385\/NCC:1:3:385","article-title":"The Contrecoup-Coup Phenomenon: A New Understanding of the Mechanism of Closed Head Injury","volume":"1","author":"Drew L. B.","year":"2004","journal-title":"Neurocritical Care"},{"key":"e_1_2_12_5_2","doi-asserted-by":"crossref","unstructured":"SabetA. A. ChristoforouE. ZatlinB. GeninG. M. andBaylyP. V. Deformation of the Human Brain Induced by Mild Angular Acceleration 22 Proceedings of the ASME Summer Bioengineering Conference (SBC 2007) 2007 863\u2013864 https:\/\/doi.org\/10.1115\/SBC2007-175638.","DOI":"10.1115\/SBC2007-175638"},{"key":"e_1_2_12_6_2","first-page":"76","article-title":"Comparative Study of Coup and Contrecoup Brain Injury in Impact Induced Tbi","volume":"54","author":"Ramzanpour M.","year":"2018","journal-title":"Biomedical Sciences Instrumentation"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.3390\/mca25020022"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000433-199806000-00002"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0973-0508(09)80004-X"},{"key":"e_1_2_12_10_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0043-1776992"},{"key":"e_1_2_12_11_2","volume-title":"Contrecoup Brain Injury","author":"Hall W. A","year":"2026"}],"container-title":["Case Reports in Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cris\/9963242","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/cris\/9963242","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cris\/9963242","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:26:54Z","timestamp":1783574814000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/cris\/9963242"}},"subtitle":[],"editor":[{"given":"Nikhat","family":"Kaura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/cris\/9963242"],"URL":"https:\/\/doi.org\/10.1155\/cris\/9963242","archive":["Portico"],"relation":{},"ISSN":["2090-6900","2090-6919"],"issn-type":[{"value":"2090-6900","type":"print"},{"value":"2090-6919","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-10-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"9963242"}}