E-Bike-Related Cranial Injuries in Pediatric Population

Purpose: E-bikes are being used increasingly by all age groups. Children riding e-bikes often do not use safety equipment such as
helmets, and are at increased risk for injuries requiring neurosurgery. The most common type of injury among pediatric e-bikers is
head and neck trauma. We describe our experience treating cranial injuries.
Methods: Data regarding children (< 18 years old) with e-bike-related cranial injuries were collected retrospectively from two
tertiary centers.
Results: Twenty patients were included. Seventeen were e-bike users, and three were hit as pedestrians. The average age at
admission was 11.3 ± 4.85 (range 1.5–17) years old. All 17 e-bike users did not wear a helmet. Seventeen of the 20 (85%)
suffered from skull fractures (70% involving the frontal bone), nine involving more than one region. Six patients (30%) had
intracerebral contusions, 3 (15%) an epidural hematoma, and 6 (30%) a subdural hematoma. Three patients (15%) underwent
surgery, two of them for depressed skull fracture reduction, and one for insertion of intracranial pressure monitor. One patient died
(5%); 1 (5%) had a Glasgow Outcome Scale (GOS) of 3, 5 (25%) had a GOS of 2, and 13 (65%) were discharged without any
neurological deficit (GOS 1).
Conclusion: E-bikes may inflict various cranial injuries, including fractures and intracranial bleeds, and may lead to significant
morbidity and mortality. Education of children to use protective gear, wide exposure of younger adolescents to traffic laws, and
limiting the use of e-bikes to older children, are all necessary actions.