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Paul S. Page, Zhikui Wei and Nathaniel P. Brooks

M otorcycle helmet laws frequently have been a point of contention over the past 50 years. Although certain safety standards have been implemented by lawmakers to diminish the inherent risks of motorcycle use, morbidity and mortality continue to be significantly associated with this activity. In 2015 alone, 88,000 motorcyclists were injured and 4594 were killed according to the National Highway Traffic Safety Administration. 13 Compared with automobile drivers, motorcyclists are 30 times more likely to die in a traffic-related accident. 5 Due to the increased

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Neurosurgical Forum: Letters to the Editor To The Editor M. W. Andre-Kildare , M.D. Des Moines, Iowa 143 143 I am calling your attention to the high incidence of head injury among patients in the 18-year-old and younger age group as a result of motorcycle and moped accidents. 2 This year, as you know, has been designated the “Year of the Child.” In conjunction with this designation and the problem of motorcycle injuries among young people, I propose that the national and state neurosurgical, neurological

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Brandon Miller, Mirza Baig, John Hayes and Scott Elton

I njuries due to MVAs are a significant cause of death and morbidity in children. Rates of injuries resulting from MVAs are higher in the US than other developed countries. 30 In 2002, motor vehicle traffic accidents were the leading cause of death in the US for individuals between the ages of 3 and 33 years. 26 Children surviving MVAs often suffer lasting disabilities due to organ, extremity, and central nervous system injuries. Although automobiles are the predominant form of transportation in the US, children are often injured during motorcycle and ATV

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David J. Daniels, Michelle J. Clarke, Ross Puffer, T. David Luo, Amy L. McIntosh and Nicolas M. Wetjen

head and spinal injuries, not much is known about the pediatric injury patterns associated with 2-wheel motorbike use. Since the 1960s, miniature motorcycles have been marketed to children for recreational and competitive use. 1 Motocross racing is a popular sport organized by the American Motorcyclist Association that includes specific events for riders 4 years of age and up. 2 Regulation varies by state. In Minnesota, there are laws protecting children and adolescents using 2-wheel off-road motorcycles. These include mandatory eye protection for all riders

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Rebecca Y. Du, Melissa A. LoPresti, Roxanna M. García and Sandi Lam

.40–57.62 million), respectively. TBI caused 8.1 million (95% UI 6.0–10.4 million) years of life lived with disability. The worldwide economic impact of the loss and decreased quality of life due to TBI is significant. The direct and indirect cost of TBI in the US alone is estimated to be $76.5 billion (in 2010 US dollars). 12 TBI occurs most often due to road traffic accidents (RTAs), specifically head injuries among pediatric and young populations riding motorcycles and bicycles. 13 , 48 Head injuries are the leading cause of death in fatal motorcycle crashes. 44 Of the

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Charles R. Loar, William M. Chadduck and G. Robert Nugent

T raumatic middle cerebral artery occlusion has rarely been discussed in the neurosurgical literature; in fact, only 20 cases have been adequately detailed and documented. 2–4, 7, 8, 10–13 We believe the entity deserves reemphasis because of its clinical similarity to other traumatic intracranial lesions, and are therefore reporting our experience with one case. Case Report A 40-year-old man was admitted unconscious to the West Virginia University Hospital 6 hours after a motorcycle accident. No description of the accident was available, but it was

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Symeon Missios, Kimon Bekelis and Robert J. Spinner

investigated PNI association with several patient characteristics. We used a regression model in a cohort of children who had sustained trauma (during motor vehicle crashes, motorcycle crashes, bicycle crashes, pedestrian accidents, other crashes, and falls) and for whom data were recorded in the 2009–2011 NTDB. The advantage of using a comprehensive database, such as the NTDB, is that it provides an adequate volume of events for studying a rare entity such as PNIs. Methods The NTDB We included in our analysis all patients who were younger than 18 years, had

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Edwin A. Takahashi, Laurence J. Eckel, Felix E. Diehn, Kara M. Schwartz, Christopher H. Hunt and David J. Daniels

involves bed rest, blood patch, subarachnoid drainage, or surgical repair. In more rare cases, pseudomeningoceles can be caused by trauma. 2 , 5 , 6 , 11 , 12 We present the case of a relatively uncommon posttraumatic anterior cervical pseudomeningocele, with symptoms of intracranial hypotension, successfully treated with a blood patch. Case Report History and Examination This 33-year-old man sustained polytrauma following a motorcycle collision with a deer. He was not wearing a helmet. He was stabilized at an outside center and transferred to our emergency

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John J. Moossy, Blaine S. Nashold Jr., Dennis Osborne and Allan H. Friedman

rootlet was avulsed. The large veins running transversely from the dorsal spinal vein mark the upper end of the avulsed roots. All six patients presented with intractable burning and shooting pains in a lower extremity. One patient had a gunshot wound of the abdomen with direct injury of the lumbar spine, and the other five patients had sustained severe pelvic trauma in motor-vehicle accidents (four were riding motorcycles and the fifth was riding a snowmobile). Case Reports Case 1 This 32-year-old man was in good health until he sustained a traumatic

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Jack E. Wilberger Jr., Mark Harris and Danial L. Diamond

motorvehicle accident in 37%; a fall in 53%; a motorcycle accident in 7%; and assault in 4%. Any patient fitting the clinical criteria for brain death on admission was excluded from study. Patients with hematomas complicating open head injury, such as depressed skull fracture or gunshot wounds, were also excluded. All patients with prolonged hypotension (systolic blood pressure < 90 mm Hg for longer than 30 minutes), hypoxia (PaO 2 < 70 mm Hg for longer than 30 minutes), or severe life-threatening injuries to any other organ system were also excluded. All patients had