Motor Vehicle Collisions and the High Incidence of Childhood Traumatic Brain Injury

By Arthur D. Leritz, Attorney At Law

In the United States, childhood motor vehicle traffic–related death rates have declined 41% in the last 10 years.  However, these deaths remain the leading cause of unintentional injury death in age groups 5–19 years, accounting for 67% of unintentional injury deaths and 28% of deaths from all causes among those aged 15–19 years in 2009.[1]  This alarming data is not unique to the United States.  Recent international studies have also confirmed that children are at higher risk for severe injury and traumatic brain injury (TBI) in motor vehicle collisions. TBI is one of the leading causes of death and disability around the world.

A 2012 study in Brazil focused on emergency medical responses to collisions on the Rio-Niteroi bridge, which is on a busy highway in Rio De Janeiro.  This study covered a one year period and covered emergency responses to 544 individuals.  Of those, 52 (4.18%) were children aged 0 to 12 years.[2]  Despite the relatively small number of children involved in this group, half of the emergency calls involved children between 6 and 12 years of age. Of the injured children, 36.54% sustained injury to the head or face.  44.23% required transport to a local hospital.

The Rio study found that children in this age group are naturally at an increased risk since they are often taken on car trips by their parents or relatives.  The study found that the highest number of injuries occurred in the month of December and that road trauma was generally higher in the summer months.  One of the very interesting findings of the Rio study was that the odds and relative risk of a child under 12 years being treated for trauma sustained while crossing the Rio-Niteroi bridge were 3.5 times higher when compared to clinical cases.  The study also found that, while none of the children involved in the study died from the trauma, all of the children sustained at least a mild traumatic brain injury, which could lead to a wide variety of outcomes, from spontaneous resolution to poorly measurable functional deficits.

A 2013 study at the University of Benin in Nigeria involving children revealed that the majority of head injuries reported were due to motor vehicle collisions.[3]  This study involved 127 children over a five year period.  The ages ranged from 3 months to 17 years.  The Benin study found that 67.7% of the brain injuries in the study recorded at the University hospital were caused by motor vehicle collisions.  The mean age of the children in the study was 7.4 years with the peak incidence of traumatic brain injury occurring at 6-8 years (24.4%).  Severe brain injuries were the most common type of head injury (40%) of 7-10 year olds.  In the youngest children of the group, 3months to 22 months, 68% of the brain injuries were due to motor vehicle collisions.

A 2013 study in Qatar also found that when it comes to moderate to severe traumatic brain injury, age does matter.  The Qatar study focused on a review of all TBIs admitted to a local trauma center between 2008 and 2011.[4]  This study involved 1665 patients, 13% of which were in the 10-20 year old range.  However, of those in the 10-20 year old range, the most common mechanism of head injury was motor vehicle collisions (51%), followed by falls from height (35%).  About half of the TBI victims were adolescents and young adults.

As these studies have shown, the consequences of children involved in motor vehicle collisions can be severe and children seem to suffer brain injuries at a disproportionally higher rate when compared to other age groups.  Whether this high rate of TBIs to children is related to developmental issues such as the size of their head, supporting neck structures, the size of the developing brain to the skull’s surface or lack of safety devices used by the occupants of the vehicle, we know that brain injuries can have a profound short term and long term impact on children and their families, and we are committed to helping those affected, whether it is from a motor vehicle collision or other events.



[2] Junior, IF, et al. Pediatric Trauma Due to Motor Vehicle Accidents on High Traffic Roadway.  Einstein (Sao Paulo) 2012; Vol. 10, No. 1:29-32.

[3] Udoh, D et al.  Traumatic Brain Injuries in Children: A Hospital-Based Study In Nigeria. Afr J Paediatr Surg 2013; 10: 154-159.

[4] El-Matbouly, M. et al.  Traumatic Brain Injury in Qatar: Age Matters – Insights From a 4-Year Observational Study.  Scientific World Journal; 2013: 354920.

Richard H. Adler Particiates in Concussion Panel on Q-13 News

Richard H. Adler participated in a roundtable interview at Q-13 television station  with Richard Ellenbogen, MD, Chairman of the Neurosurgical Services at Harborview/UW Medicine, Jim Miller of the Washington Interscholastic Activities Association (WIAA), Stan Herring, MD, Co-Medical Director of the Seattle Sports Concussion Clinic at Harborview Medical Center, and the Lystedt Family regarding the “Zackery Lystedt Law”, the nation’s first return-to-play law aimed at preventing preventable brain injuries in youth sports by requiring medical clearance of youth athletes suspected of sustaining a concussion before sending them back into a game, practice or training.

Q13 Interview

John Miller, WIAA; Marni Hughes, Q-13 News; Mercedes Lystedt; Stanley Herring, MD; Zackery Lystedt; Victor Lystedt; Richard Ellenbogen, MD; Richard H. Adler

Seventh Annual Brain Injury Association of Washington Gala

Adler ♦ Giersch PS attended the seventh annual benefit auction for the Brain Injury Association of Washington, the Brain Injury Gala.  The law firm was a sponsor for the event and hosted six tables.  The auction raised over $425,000, a new record for the association.  Washington State Attorney General, Bob Ferguson, served as the Honorary Chair.

BIAWA Gala

BIAWA Executive Director Deborah Crawley, Award Recipient Tommy Manning, Richard H. Adler, and Washington State Attorney General Bob Ferguson.