Brain Injuries and Road Traffic Accidents
Whilst there are a number of causes of brain injury, nearly half of all acquired brain injuries are as a result of road traffic accidents. This takes into account drivers and passengers in vehicles, motorcyclists, cyclists and pedestrians. With the brain injury charity, Headway, estimating that there were nearly 350,000 UK admissions to hospital with acquired brain injury in 2013-14, this underlines the scale of brain injury suffered by road users.
Without the inbuilt protection and safety of a car, motorcyclists, cyclists and pedestrians are particularly vulnerable. Latest research shows that motorcyclists in the UK are nearly 40 times more likely to die in a road traffic accident compared to car drivers.
There is some positive news though. Statistics provided by The Royal Society for the Prevention of Accidents reveal that the overall trend in road deaths in the UK is downwards, with the total number of casualties reducing from 3,201 in 2005 to 1,713 in 2013. Their figures also show that the number of people sustaining serious injuries in road accidents is reducing year on year, with a drop of 43% between 2000 and 2013.
One area of particular concern though is that the number of serious and fatal accident involving cyclists is not following this downward trend. In recent years the number of fatal accidents involving cyclists has fluctuated with no obvious downward trend, whereas the number of cyclists seriously injured has increased in recent years.
Motor vehicle drivers and passengers
The mechanism of a motor accident means that drivers and pedestrians are vulnerable to brain injury despite improvements in vehicle safety design and technology.
A traumatic brain injury can occur when the head is thrown forwards and then backwards following the sudden deceleration of the car on impact. This results in the brain being violently shaken inside the skull causing damage to the brain. A brain injury may also arise when the head is struck and penetrated by an object following a collision. This is known as an open head injury and results in direct trauma to the brain.
There are different types (and severity) of brain injury but the most common arising from a road traffic collision are:
- Concussion (sudden, short lived loss of mental function following blow to the head)
- Diffuse axonal injury (disruption to the connecting fibres in the brain)
- Contusion (bruising and swelling to the brain)
- Haemorrhage (bleeding in or around the brain)
- The symptoms can vary depending on the type and severity of the injury but can include:
- Loss of consciousness, either briefly or prolonged
- Drowsiness and tiredness.
- Leaking fluid from the nose or ears
- Difficulty speaking
- Confusion and difficulty understanding what people say
- Loss of coordination and balance problems
- Loss of power in limbs
- Memory problems
Motorcycling is becoming increasing popular with the sales of scooters and motorcycles increasing steadily over the past few tears. The risks of motorcycling are well-known - riders are particularly vulnerable to serious injury due to the fact they have limited safety protection compared to cars.
Head injury is the main cause of serious disability and fatalities in motorcycle accidents. Helmets provide good protection and reduce the risk of serious injury, particularly for accidents at low speeds, but at higher speeds the level of protection is reduced and the number of serious injuries has risen in recent years.
There are risks specific to motorcyclists. The main cause of accidents involving motorcyclists is the failure of car drivers to see and respond to the approach of a motorcyclist. This is partly due to the comparative difficulty in observing motorcyclists despite the fact it is now commonplace for riders to wear hi-visibility clothing. However, perhaps surprisingly, the majority of motorcycle accidents (74%) happen in urban areas and at speed limits below 40mph, although the more serious accidents tend to happen at higher speeds.
Research has identified 4 main causes of motorcycle accidents:
- Collision at junctions
- Collision whilst overtaking
- Failure to negotiate a bend, usually on rural A roads
- Rider losing control
- Accident research has shown that collisions at junctions and whilst the motorcycle is overtaking can be just as easily caused by the other vehicle.
The popularity of cycling in recent years has resulted in more and more riders on the roads and tragically this has coincided with an alarming increase in the number of fatal and serious accidents involving cyclists. In London in 2014, there were 432 cyclists who were seriously injured or killed on the roads. In response there are a number of road safety campaigns, such as Think!, who are promoting road safety for drivers and cyclists. The benefits are yet to be reflected in falling numbers of serious accidents.
As with motorcyclists, pedal cyclists are at increased vulnerability to serious injury. Following an impact, cyclists are often thrown with force to the ground and can suffer a blow to the head. The wearing of cycling helmets is recognised to reduce the risk of injury at low speed but there effectiveness in providing protection in higher speed collisions is less certain.
The risks relating to cycling apply equally to children. The majority of accidents involving cyclists are overwhelming adults but the risk of serious injury to children, particularly as they grow older and use the roads, is significant.
Statistics based on accidents reported to the police show that the most common types of accidents involving cyclists are:
- Motorist emerging into path of cyclist
- Motorist turning across path of cyclist
- Cyclist riding into the path of a motor vehicle, often riding off a pavement
- Cyclist and motorist going straight ahead
- Cyclist turning right from a major road and from a minor road
- Child cyclist playing or riding too fast
Head injuries are a common occurrence with hospital admission statistics showing that over 40% of cyclists, and 45% of child cyclists, suffer head injuries.