Motorcycling and head injury: admissions to a regional head injury unit

In a 5-year period during which 7,178 patients with head injury were admitted to a regional head injury unit, 191 motorcyclists (2.7%) were admitted with head injuries of which 76% were classified as minor, 6% as moderate and 18% as severe (in coma). Two thirds of the patients were aged 20 years or less. Eighty-two riders (43%) had some form of facial or scalp trauma and 37 (19%) sustained skull fracture. Intracranial haematomas requiring surgical evacuation were detected in 3 of the minor head injuries (2%), 2 of the moderate injuries (17%) and 11 of the severely head injured patients (32%). Twenty-nine of the 34 severely injured patients were managed using artificial ventilation and intracranial pressure monitoring. The remaining patients died before these measures could be instituted. Overall mortality was 7%, but deaths were restricted to the severely head injured, among whom there were 13 fatalities. Head injuries associated with motorcycle riding include an unduly high proportion of severe cases and occur in a young population, often within a short time of starting to ride a motorcycle. Protective headgear was virtually always worn (94%); to reduce morbidity further, increased training and supervision during the first 6 months of motorcycle ownership should be emphasized.