Patterns of head injury in injured motorcyclists wearing helmets and not wearing helmets presenting to the emergency

Background: Injury from motorcycle is a considerable cause of deaths and disability. It is becoming one of the most serious public health problems, not only in developed countries but higher in low and middle-income countries. Aim: Current study aimed to compare the patterns of head injury in injured motorcyclists wearing helmets and those not wearing helmets presenting to the emergency department of a tertiary care institute and to identify the impact of helmet use on severity of traumatic brain injury. Method: An observational cross sectional study for patients who sustained head injuries related to motorcycle crashes between March 2014 and March 2015. A total of 200 patients were selected of which 100 wearing helmet and 100 not wearing helmet, in the age group 18-80 years. Participant bio data, injury history, injury associated symptoms, alcohol consumption, and neurological findings, and Glasgow Coma Scale were measured using questionnaires. Frequencies, Mean (SD) and chi-square was employed in the analysis. Results were considered significant at p<0.05. Results: 18-38 years age(58.50%) was the most common group to sustain a head injury. The most common presenting complaint was vomiting (64.5%) followed by loss of consciousness (60.5%; n=121), post traumatic amnesia (20%). 31 % ENT bleeding, and 22 % seizure. 45 % of patients had a GCS score of moderate head injury(9-12), 34.5% in score 13-15, and 20.5%had score of 3-8. Among the helmet wearers, 26% had history of alcohol consumption, 22% among the non helmet wearers had alcohol consumption. 82.1% (n= 23) of non-helmet wearers had an EDH greater than 10 mm size. Among the patients with SAH with a midline shift ≥ 5mm was seen in 25.9% patients who wear helmet wearers, and 74.1% were not having a helmet during the insult. The size of EDH was greater in non helmet wearers. Most of the helmet wearers have mild traumatic brain injury whereas non helmet wearers had more severe TBI (p= 0.04). Helmet wearing reduces the size of contusion (p=0.001) following TBI. the helmet wearers 25% (n=2) died, and among the non helmet wearers 75%(n=6) died(P = 0.14). Conclusion: Majority of motorcycle crash injury victims sustained head injury. Few of the victims used safety helmets at the time of the motorcycle crash. Use of helmets was protective of sustaining mild to severe head injuries among crash injury victims. Medical professionals must educate the public regarding the societal and personal cost of unhelmeted motorcycle riding. Legislation mandating helmet usage for motorcycle riders must be sought