Focal Brain Injury (local)

The opposite of scattered or diffuse injuries is local injury or focal injury. The brain can be locally damaged at the site of a bleeding or a blow or a tumor.

This condition is also called focal pathology. The word pathology means disease. Focal pathology is a condition in one specific place in the body.


Coup and contrecoup

In case of a strong movement of the head in the event of a fall or blow, injury can also be caused by the recoil of the shaken brain against the inside of the skull, on the opposite side. In general this is an abrupt delay of the head because the head bumps against something hard.

Then there is focal injury, a damage at the place where the trauma (for example the stroke) occurred (coup) and / or at the location on the other side of the brain from the location of the trauma in the direction of the force of the trauma (contrecoup).

This usually happens after a blow to the head, which often causes a skull fracture. There is often a contusion in the brain under the skull fracture. Coup and contrecoup injuries can also occur separately.

Coup injuries are the most recognizable form of traumatic brain injury. Bruises, cuts, indentations, and bruises can be visible at the head, but can also occur inside the brain.

Contrecoup lesions are more difficult to identify because they have the effect on the other side of the brain where collision or damage initially occurred. There is high possibility that these lesions are missed by the doctor in making a diagnosis.


Not always is injury visible on an MRI. This causes a great deal of suffering among people who suffer from the consequences of brain injury, but who are faced with insurance physicians or company doctors who demand hard evidence. More often than an MRI, a PET scan or PET MRI, f-MRI or a spect scan can show a blood flow disorder.

A neuropsychological examination can show hidden damage. Ask your neurologist for another investigation if an MRI scan shows nothing and you continue to have complaints.

MRI is an abbreviation for Magnetic Resonance Imaging, also called nuclear spin tomography.