Cyclists fatalities: Forensic remarks regarding 335 cases

A Review of Cyclist Head Injury, Impact Characteristics and the Implications for Helmet Assessment Methods

“…There was an almost exactly even split between those who wore a helmet (46, 49% of 94 cyclists) and those who did not (48, 51% of 94 cyclists) Hospital (mixed, all-severity settings) Feler 34 Adult cyclists identified using ICD10 in the USA’s National Trauma Data Bank® 2017 Skull fracture and intracranial haemorrhage were common in cyclists, with skull fracture more prevalent in male cyclists 36.4% (6,768/16,181) of cyclists in this cohort wore a helmet Neuro-surgical Admissions Depreitere et al 25 Belgian neurosurgical admissions 1990–2000 Skull fractures were most prevalent (86%), followed by brain contusions (73%) and subdural haematoma (43%) 83/86 non-helmeted and 3/86 helmeted bicyclists Park et al 88 Cyclist admissions to a Korean neurosurgery department 2007–2016 Skull fracture was the most prevalent pathology followed by subdural haematoma, subarachnoid haemorrhage, intracerebral haemorrhage and haemorrhagic contusion. Subdural haematoma incidence increased with age, as did other intracranial bleeds Helmet use not accurately recorded and therefore not included Fatally Injured Cyclists Piras et al 94 Fatalities from the Brescia institute, Lombardy region, Italy 1983–2012 Common injuries included skull base fractures (117), cranial vault fractures (116), facial skeleton fractures (37) No helmeted cyclists included in the sample We separate the studies by data source group, to highlight differences between findings. We provided details of the specific dataset and years of data, a summary of the key findings relating to injury type and any factors of influence from the study and report the proportion of helmet use.…”

“…At a high level, the literature identifies skull fracture, subdural haematoma and subarachnoid haemorrhage as being the most common severe TBI pathologies for cyclists. 4 , 16 , 26 , 29 , 34 , 36 , 22 , 61 , 72 , 77 , 94 Mild injuries such as soft tissue injuries and short periods of loss of consciousness are prevalent in less severely injured cohorts. The data sources with sufficient data available for analysis frequently come from settings which treat and capture a high proportion of severe TBI.…”

“…Piras et al . 94 examined 335 fatal cyclist collisions from 1982 to 2012 and found that skull fracture, particularly basilar skull fracture, was very prevalent. 94 A small study examined TBI in 22 paediatric cyclists.…”

“… 94 examined 335 fatal cyclist collisions from 1982 to 2012 and found that skull fracture, particularly basilar skull fracture, was very prevalent. 94 A small study examined TBI in 22 paediatric cyclists. This is important, as children make up 25% of RTC fatalities and two thirds of those deaths are caused by TBI.…”

“…As bicycle collisions involving motor vehicles tend to have more severe outcomes, they are more likely to be captured by datasets used for analysis in the literature. 94 Within the papers reviewed for this study, there is an even split between impacts with a vehicle ( i.e. , a motor vehicle collision) and with the ground ( i.e.…”