E-bike-related cranial injuries in pediatric population

  • Yevgeny Karepov
  • Danil A. Kozyrev
  • Moni Benifla
  • Vladimir Shapira
  • Shlomi Constantini
  • Jonathan RothEmail author
Original Article



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.


Data regarding children (< 18 years old) with e-bike-related cranial injuries were collected retrospectively from two tertiary centers.


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).


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.


E-bikes Neurosurgery Head injury Helmet Children 



We thank Mrs. Adina Sherer for editorial assistance. We would like to thank Ksenia A. Ermolenko and Yaroslava A. Kozyreva for the drawing in this article.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Pediatric Neurosurgery, Dana Children’s Hospital, Tel-Aviv Medical CenterTel-Aviv UniversityTel AvivIsrael
  2. 2.Pediatric Neurosurgery UnitRambam Health Care CampusHaifaIsrael

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