title: Bicycle accident-related head injuries in India.
abstract: OBJECTIVE
  To describe the epidemiology of head injuries sustained due to bicycle accidents in India.
  
  
  METHODS
  Data were retrospectively collected over a period of six months (15 May 2011 to 15 November 2011). Demography of patients, Glasgow coma scale (GCS), clinical and imaging findings, and mortality and outcome using Glasgow outcome scale (GOS), Rivermead post-concussion symptom questionnaire (RPCSQ) and Rivermead head injury follow-up questionnaire (RHFUQ), were analyzed. Outcome was assessed by telephonic interview.
  
  
  RESULTS
  There were 108 patients (100 males) with mean age of 27.7 years. Seventy-four (68.5%) were from rural areas. Accidents due to vehicular collision accounted for 60 (55.6%) cases. None wore a helmet. The admission GCS was 14-15 in 68.5% cases, 13-3 in 31.5%. The risk of moderate to severe injuries was increased among working laborers (OR = 5), and patients with loss of consciousness (OR = 4). Sixty-three (49%) patients had abnormal computed tomography (CT) findings; most common finding was skull fracture 25 (23.1%). Four patients needed surgery. The GOS assessment at three to six months revealed favorable outcome in 66 patients (61.1%) and death in 8 (7.4%). The common post-concussion symptoms were headache, fatigue, and poor concentration.
  
  
  CONCLUSIONS
  The majority of hospitalized cyclists were from a rural background and of the lower income group. After three months the majority of patients had good recovery with few persistent concussion symptoms.
authors.affiliation: Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India.
authors.forename: Ashok
authors.initials: A
authors.lastname: Munivenkatappa
authors.forename: Bhagavatula Indira
authors.initials: BI
authors.lastname: Devi
authors.forename: Thomas Issac
authors.initials: TI
authors.lastname: Gregor
authors.forename: Dhananjay I
authors.initials: DI
authors.lastname: Bhat
authors.forename: Akhil Deepika
authors.initials: AD
authors.lastname: Kumarsamy
authors.forename: Dhaval P
authors.initials: DP
authors.lastname: Shukla
keywords: Bicycle; glasgow outcome scale; head injury; outcome; rivermead post-concussion symptom questionnaire