Neurological Outcomes and Helmet Use among Motorcyclists Admitted to a Tertiary Neurosurgical Center in Pakistan

Abstract

Objective: To determine neurological injury patterns, severity, outcomes, and helmet use prevalence among motorcyclists admitted to a tertiary neurosurgical unit.
Results: We enrolled 113 patients (mean age 26.9 ± 17.5 years; 85.0% male). Helmet use was 1.8% (n=2). Drivers
comprised 62.8% and passengers 37.2%. Predominant diagnoses were traumatic brain injury (26.5%), extradural
hematoma (15.9%), brain contusion (15.0%), and subarachnoid hemorrhage (14.2%). On admission, 69.0% had
mild, 18.6% moderate, and 12.4% severe head injury. Conservative management was performed in 86.7% (n=98),
and 13.3% (n=15) underwent surgery. ICU admission was required for 8.0% (n=9). Median hospital stay was 2
days (IQR 1–2). Overall mortality was 8.0% (n=9), all among non-helmeted riders. The two helmeted patients
sustained only mild injuries, required no surgery or ICU care, and were discharged without complications.
Conclusion: Helmet use was rare but associated with milder injuries and zero mortality. Strengthened
legislation, enforcement, and public education are urgently needed to reduce preventable neurotrauma.
Keywords: Helmet use; traumatic brain injury; motorcycle crash; neurosurgical outcomes; Pakistan.