====== Bicycle helmet ====== Prevention of serious [[bicycle]] injuries cannot be accomplished through helmet use alone, and may require separation of cyclists from motor vehicles, and delaying cycling until children are developmentally ready ((Rivara FP, Thompson DC, Thompson RS. Epidemiology of bicycle injuries and risk factors for serious injury. Inj Prev. 1997 Jun;3(2):110-4. doi: 10.1136/ip.3.2.110. PMID: 9213156; PMCID: PMC1067791.)). ---- [[Motorcycle helmet]]s provide protection to adult motorcyclists involved in traffic accidents and their use is associated with a decrease in mortality rates and the risk of head injuries. However, no such protective effect of helmet use was observed for bicyclists involved in collisions ((Kuo SCH, Kuo PJ, Rau CS, Chen YC, Hsieh HY, Hsieh CH. The protective effect of helmet use in motorcycle and bicycle accidents: a propensity score-matched study based on a trauma registry system. BMC Public Health. 2017 Aug 7;17(1):639. doi: 10.1186/s12889-017-4649-1. PMID: 28784110; PMCID: PMC5545860.)) ---- [[Bicycle]] [[helmet]]s may offer less protection to females compared with males. The cause of this sex or gender-based difference is uncertain, but there may be intrinsic incompatibility between available helmets and female anatomy and/or sex disparity in helmet testing standards ((Feler J, Maung AA, O'Connor R, Davis KA, Gerrard J. Sex-based differences in helmet performance in bicycle trauma. J Epidemiol Community Health. 2021 Oct;75(10):994-1000. doi: 10.1136/jech-2020-215544. Epub 2021 Apr 7. PMID: 33827896.)). ---- Patients who wore helmets were significantly less likely to suffer from epidural hematomas and open head injuries. While TBI severity was not significantly different between helmeted and non-helmeted bicyclists, the overall occurrence of TBI and moderate to severe TBI among all admissions was lower than that seen in comparable studies from countries without helmet laws ((Baschera D, Lawless A, Roeters R, Frysch CWS, Zellweger R. Severity and predictors of head injury due to bicycle accidents in Western Australia. Acta Neurochir (Wien). 2021 Jan;163(1):49-56. doi: 10.1007/s00701-020-04626-w. Epub 2020 Oct 28. PMID: 33113011.)). ---- Helmeted patients involved in bicycle crashes are less likely to sustain a serious head injury, a skull fracture, or facial fractures compared to riders without helmets. The most common injury in patients with a bicycle crash is a [[concussion]]. Helmets did not prevent concussion after bicycle rider's crash in our patient population ((Alfrey EJ, Tracy M, Alfrey JR, Carroll M, Aranda-Wikman ED, Arora T, Maa J, Minnis J. Helmet Usage Reduces Serious Head Injury Without Decreasing Concussion After Bicycle Riders Crash. J Surg Res. 2021 Jan;257:593-596. doi: 10.1016/j.jss.2020.08.009. Epub 2020 Sep 12. PMID: 32932191.)). ---- Helmet use demonstrated a statistically significant advantage in the prevention of traumatic brain injuries. No significant difference was found regarding the incidence of severity of cervical spine injuries. These results do not demonstrate any statistically significant benefit in the prevention of cervical spine injuries with helmet use. In contrast, helmet use was found to convey a significant protective advantage in the prevention of traumatic brain injuries compared to no helmets ((Page PS, Burkett DJ, Brooks NP. Association of helmet use with traumatic brain and cervical spine injuries following bicycle crashes. Br J Neurosurg. 2020 Jun;34(3):276-279. doi: 10.1080/02688697.2020.1731425. Epub 2020 Feb 28. PMID: 32106719.)). ---- E-bikers had a significantly greater risk of moderate to severe TBI compared with bicyclists. Helmet use was associated with decreased odds of severe TBI in bicyclists and a tendency toward a more favorable outcome for E-bikers ((Baschera D, Jäger D, Preda R, Z'Graggen WJ, Raabe A, Exadaktylos AK, Hasler RM. Comparison of the Incidence and Severity of Traumatic Brain Injury Caused by Electrical Bicycle and Bicycle Accidents-A Retrospective Cohort Study From a Swiss Level I Trauma Center. World Neurosurg. 2019 Jun;126:e1023-e1034. doi: 10.1016/j.wneu.2019.03.032. Epub 2019 Mar 9. PMID: 30857998.)).