Investigation of real-world serious brain injuries in the absence of skull fractures

Abstract
Improvements to vehicle interior, restraint and airbag designs have reduced head injuries. However, serious head injuries continue to occur in real-world crashes, and the risk of severe brain injuries is higher (7%) than the risk of skull fractures (3%). The mechanisms of brain injuries without skull fractures and the population sustaining such injuries have not been explored using real-world crash data. This study compares crashes in which the driver sustained a serious brain injury accompanied by a skull fracture with crashes in which a serious brain injury occurred but no skull fracture.