The e-bike injury crisis
As powerful electric bikes become a teenage status symbol, serious head injures are increasingly common
By: Dr, Blake Taylor
Opinion contributor
.... I was the brain surgeon on call in the Marin County, California, hospital one evening when the emergency room paged me. A 15-year-old girl came into the hospital with severe head trauma after falling off a friend's e-bike, within seconds of trying it out.
..... Immediately, we discovered that her skull was fractured and hat the large blood vessels surrounding her brain we torn. The blood was pouring out of the vessels, rapidly polling inside her brain, pressing and squeezing her brain stem - a vital brain structure that controls breathing.
..... The pressure inside skull was rising rapidly and, if not treated immediately, it could have cause irreversible brain damage. I rushed her into my operating room, drilled and removed here entire right side of her skill.
..... I vacuumed up the blood and stopped the bleeding at its source. It was a matter of life or death. It took most of the night.
..... In the early morning, she was helicopter to the children's hospital across San Francisco Bay. More surgeries, eight weeks in intensive care and a year of recovery awaited her, all because of an impulsive e-bike ride.
..... Sadly, she wasn't my only young patient who suffered injuries as a result of electric bikes. There have been a succession of patients who have fallen off e-bikes and e-scooters - one patine only 5 years old - whom I've treated with these traumatic brain injuries hat require emergency surgery.
E-bike injuries aren't getting enough attention
..... What is missing from the debates surrounding e-bike freedoms and regulations is the focus on the injuries that happen when youths crash their bikes.
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If parents, youths, the public and elected officials only knew. If they could see the internal injuries and what happens in my operating room, and in many trauma center across the country, and what it takes to save these lives or prevent devastating disabilities, maybe they would rethink their priorities.
..... I, along with a growing nationally physicians and legislators nationally am advocating for e-bike education, training, commonsense regulation and enforcement. These e-bike injuries are not like those associate with traditional bikes. They are more like motorcycle injuries, and the risk of dying is greater. Those who survive may deal with concussions, comas, skull fractures, tearing of brain tissue, brain swelling and bleeding.
Crashes often lead to brain injuries
..... Why are these injuries so devastating to the brain? Many people don't realize that blood is toxic to the brain (when outside of normal blood vessel walls) and can damage or kill brain tissue.
..... Then there's the problem of brain pressure. Because the brain is encased in a hard, inflexible skill, if the brain swells, it cannot expand and thus presses up against the skull.
..... The pressure builds quickly and damages brain tissue. There are other complications too.
..... Often, these brain injuries occur wit other bodily injuries: They include broken spinal cords, pelvic bones and facial bones. We are discovering that e-bikes' powerful motors, sudden acceleration, heavy weight, high speeds (some exceeding 30 mph) and momentum can cause riders to lose control.
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Young people often don't war helmets and aren't trained to use electric vehicles. Nor are they educated about traffic rules.
..... Youths can modify e-bike maximum speeds with software fixes. Add to this mix the rise of illegal bikes, with speeds of 70 mph, that are advertised as e-bikes and, officials say, are becoming status symbols among teenagers who are too young to legally drive cars.
..... Riders are not the only ones getting hurt, e-cyclists are also hurting killing others. Recently, in the suburbs of San Francisco, an e-bike collided with a car, causing a chain-reaction accident that killed a 4-eyar-old who was playing on the sidewalk.
..... In Davis, California, a nurse riding her conventional bike collied with an e-bike. She fell, hit her head and died. Pedestrians are being hit, too, as has happened repeatedly in New York City.
Regulations, common sense can reduce the risk
..... E-bikes are gaining popularity even as more variations on them are being produced. meanwhile, states have patchworks of legislation trying to regulate their speeds, power, rider ages, helmet usage, permitted paths, licensing, registration, consumer disclosure requirement and illegal modification.
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In California, fro example, elected officials have proposed at least nine e-bike bills since January. [2026] Not all of them were approved, but some are still under consideration.
..... Communities like Hisbrough, California, are getting the word out by holding town halls, education and training sessions for parents and youths, e-bike safety social media contests, and youth commission seminars.
..... There are steps we can take now. Let's listen to our national medical associations. The American College of Surgeons, the American Association of Neurological Surgeons, the Congress of Neurological Surgeons and the American Academy of Orthopedic Surgeons have all issued safety recommendations for e-bike and e-scooter injury prevention:
* Promote helmet sue.
* Limit top speeds.
* Enforce safe-riding practices.
* Encourage relicense and registration.
* Prohibit riding under the influence
..... Parents don't wait to take precautions. you don't want your child or teen ending up in an operating room like mine.
..... Blake Taylor, a neurosurgeon, is an assistant clinical professor in the department of Neurological Surgery at the University of California-San Francisco.