A group of young kids ride blue and yellow colored bikes all wearing helmets outside on the street at an event

Bicycle riding can lead to traumatic brain injuries and concussions in children, with head injuries being the most common cause of serious disability and death in bicycle crashes.

While many people don't immediately associate concussions with traumatic brain injuries (TBIs), they are a common form of brain injury that can range from mild to severe. TBIs, which occur when a sudden blow to the head disrupts normal brain function, are divided into three main categories: mild, moderate, and severe.

Unlike moderate or severe TBIs, concussions typically do not cause loss of consciousness or paralysis. However, they can still lead to persistent issues such as headaches, memory problems, confusion, and drowsiness.

Miguel Lopez-Gonzalez, MD, a neurosurgeon at Loma Linda University Health, warns that symptoms from a head injury can last for days or even weeks. Repetitive concussions over time can potentially lead to lasting cognitive and behavioral issues, including memory deficits, confusion, and even conditions like dementia, making early recognition and proper recovery essential.

The three stages of TBIs

A mild TBI is a blow to the head that does not cause bleeding or require urgent intervention. Although the injury to the head might be mild, this category of TBI is still commonly associated with concussions and can lead to temporary confusion, memory issues, and cognitive difficulties that persist for days or weeks. In many cases, standard imaging tests like CT scans and MRIs appear normal, even when symptoms are present. Lopez-Gonzalez says that it is crucial to prevent repeated head injuries, as multiple concussions can contribute to long-term neurological damage.

Moderate TBIs require hospitalization for observation, as patients may exhibit more significant symptoms but do not necessarily need immediate surgical intervention. It’s important that a patient undergo observation for a moderate TBI to determine if intervention is necessary.

Severe TBIs can lead to serious complications such as brain bleeds, loss of consciousness, or coma. These injuries often require emergency surgery.

Causes of TBIs

TBIs can result from a wide range of incidents, from minor accidents at home to severe high-impact collisions. 

Lopez-Gonzalez says that everyday situations, such as hitting your head on a cabinet, bumping into a doorframe, or standing up too quickly and hitting your head on an overhead compartment, can lead to mild TBIs like concussions. Falling out of bed, tripping on uneven flooring, or slipping on stairs can also result in head injuries, sometimes with serious consequences.

Beyond household accidents, recreational activities and sports also pose risks. 

“Cycling, skating, skiing, snowboarding, and surfing are all common causes of head injuries, particularly when proper safety gear isn’t worn,” Lopez-Gonzalez warns. “Contact sports such as football and soccer can also lead to concussions, especially from collisions or falls. Even seemingly minor impacts during these activities can cause temporary or lasting cognitive effects.”

While everyday situations and sports pose a serious risk of TBI, car accidents and motorcycle crashes are among the leading causes of severe TBIs. While high-speed collisions are often associated with these injuries, even a lower-speed accident can result in significant head trauma. 

These injuries can range from mild concussions to life-threatening brain damage requiring urgent medical intervention.

Ultimately, TBIs can occur in nearly any environment, and while some risks are unavoidable, awareness and precautionary measures can help reduce the likelihood of serious injury.

Concussions and potential long-term effects 

Concussions are a significant concern among athletes, particularly as more research emerges about their long-term effects. In recent years, organizations like the NFL have taken head injuries more seriously due to studies linking repeated concussions to chronic traumatic encephalopathy (CTE), a condition caused by repeated head trauma.

There is no specific medication to treat concussions, and the primary approach is rest. In some cases, individuals who have suffered a concussion may also be at a slightly increased risk of seizures, making rest and monitoring even more essential. While concussions are often considered "minor," persistent symptoms or repeated injuries can lead to severe, lasting effects.

Various sports contribute to concussions, with football, boxing, and mixed martial arts among the most well-known for head injuries. However, other activities, including car racing, motorcycle riding, and even non-contact sports, can still lead to serious head trauma. Regardless of the sport, recognizing and addressing concussions promptly is crucial to preventing long-term neurological consequences.

ThinkFirst

The ThinkFirst program is an international initiative established in the 1980s to promote injury prevention, particularly focusing on traumatic brain injuries. In the Inland Empire, the program operates a local chapter dedicated to spreading awareness and education about injury prevention.

“One of the key aspects of the ThinkFirst program is its focus on educating children and teenagers to instill safe behaviors before risky situations arise,” Lopez-Gonzalez says. “Presentations tailored to different age groups cover essential topics such as playground safety, de-escalating conflicts, and the importance of securing weapons at home.” 

For high school students, ThinkFirst incorporates speakers who have experienced life-altering injuries due to preventable accidents. These individuals share their stories of becoming paraplegic, quadriplegic, or undergoing extensive medical interventions after a single split-second decision changed their lives. By hearing firsthand experiences, students can relate to these individuals and understand how everyday activities, like playing sports or making impulsive choices, can have severe consequences.

“The majority of TBIs could have been prevented,” Lopez-Gonzalez says. “It’s crucial to teach kids to make the right choice and help prevent potential life-altering injuries.”

When a patient has an accident involving a head injury, Lopez-Gonzalez says it's better to be overcautious and go to urgent care or the emergency department for assessment. 

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