Clinical and pathological studies of brain injuries in horse-riding accidents: a description of cases and review with a warning to the unhelmeted.

We present a clinical and pathological study of brain injuries in horse-riding accidents. Among six fatal cases, all experienced riders varying in age and sex, two were not wearing helmets and four had inadequate protective headgear. Among five non-fatal cases, four wore adequate helmets and only one of these suffered permanent neurological damage. The fifth was not wearing a helmet and although he eventually returned to work, a CT scan following the fall showed a deep-seated perithalamic hematoma. These findings are consistent with those of virtually all other studies in that they suggest that the present type of riding helmet is inadequate and largely unable to absorb the shock of a normal fall. We hope these findings will serve as a warning to those who choose to ride unhelmeted.