Authors: Shiyang Meng, Autoliv Research & KTH Royal Institute of Technology, Sweden; Ron Schindler, Autoliv Research, Sweden & Autoliv BV & Co. KG, Germany; Svein Kleiven, KTH Royal Institute of Technology, Sweden; Nils Lubbe, Autoliv Research & Chalmers University of Technology, Sweden
Abstract
Road traffic crashes are a major cause of traumatic brain injury (TBI), particularly among vulnerable road users
(VRUs). However, current injury prevention strategies often overlook the heterogeneity of TBI—which include various injury
types and severities—leading to an oversimplified approach to evaluating helmets and safety systems in regulations and ratings.
To identify priority TBI types and severities in VRUs and to inform targeted prevention strategies, the German In-Depth Accident
Study database was analyzed and a pathoanatomic classification system, i.e., Abbreviated Injury Scale, was employed. AIS 2
(moderate) TBIs account for 70-80% of all brain injuries across VRU groups, nearly half of which are concussions. For helmeted
cyclists, milder TBIs are at a greater percentage than for unhelmeted cyclists. These findings highlight the need for expanding
prevention efforts to include AIS 2+ injuries. Key injury types observed include concussion (with and without loss of
consciousness), skull base fracture, subdural hemorrhage, contusion and laceration. New mechanism-specific injury criteria may
be needed to address these injuries. The strong similarity in injury type ranking among different road users (the Kendall’s tau values ranged from 0.90 to 0.93) suggests similar needs for injury prevention. A new brain injury assessment criterion may serve all road user types.
Type: Full Paper, Research
Keywords: Road traffic crashes, Traumatic brain injury, injury prevention, helmet
© Stapp Association, 2026
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