Pedestrian Accident Brain Injuries

While the odds of suffering a pedestrian brain injury after being hit by a car in California are much lower than your risk of suffering other more common pedestrian injuries (such as broken legs or arms), the effects of Traumatic Brain Injuries (TBI) can be devastating. Indeed, unlike other injuries you might suffer, pedestrian brain injuries can be immediately fatal even at speeds as low as 25 MPH. In addition, any injury to the brain can take months or even years to repair—if, indeed, recovery is even possible. In fact, most people who suffer pedestrian brain injuries after being hit by cars never fully recover.

What are the Odds?

Your overall odds of being injured during a collision with a car while walking along the sidewalk, crossing the street, or even traveling along the shoulder of the road in California are roughly 36 in 100,000. Your risk of dying in such a collision is roughly 16 times less than that (2 in 100,000).

However, one study found that nearly half (44%) of all Traumatic Brain Injuries are caused by car accidents, meaning that collisions between pedestrians and automobiles are one of the most common causal events for brain injuries in the world.

What’s the Probability of Pedestrian Brain Injury When Getting Hit by a Car?

According to an intensive scientific study designed to understand the mechanics of head trauma during pedestrian accidents, “there is an 18% probability of a severe head injury, a 55% probability of a serious injury and a 90% probability of a moderate head injury to the average adult.”

In short, up to 90% of victims struck by cars can expect to suffer at least some form of head injury—even if it’s just a minor laceration.

Surviving Pedestrian Brain Injuries is Just the First Step

Pedestrians who survive after suffering brain injuries caused by being hit by a car are extremely lucky from a certain point of view. Roughly 40% of such victims either die immediately or shortly after the collision in hospital ICUs. That mortality rate is tremendous mostly because of the delicate nature of the brain. Even if the skull isn’t fractured in the crash, your brain behaves much like a liquid would in a collision. It “sloshes” around inside the skull and can actually tear itself apart.

And, even if the brain isn’t injured badly in the initial crash, swelling, internal bleeding, and increased cranial pressure that occur during the recovery process can lead to serious and sometimes fatal complications.

The Majority of Pedestrian Brain Injuries Have Long-Term Consequences

It’s no wonder then that only 46% of victims who survive brain injuries after being hit by a car get what doctors term “favorable outcomes.” That means the vast majority of survivors are left struggling with serious, debilitating, or even crippling side effects of TBI long after they’ve ostensibly recovered from their accidents.

Such long-term side effects include:

  • ​Paralysis (partial or complete)

  • ​Loss of motor control

  • ​Speech di​​​​sabilities

  • ​Learning disabilities

  • ​The inability to control moods

  • Persistent Vegetative States

Speed is a Pedestrian’s Worst Nightmare

While much has been made about the recent rise of distracted driving, speed is still often the top contributing factor to pedestrian accidents here in California. When drivers disobey the speed limit or travel too quickly for the road conditions, their chances of being involved in an accident are greatly multiplied.


  • Reduces reaction time

  • Increases the risk for miscalculation (overcorrection)

  • Increases force of impact

Unfortunately, speed also contributes to the severity of pedestrian brain injury after being hit by a car. In fact, only one other contributing factor (direction of impact) has so great an influence on how much damage a victim’s brain will suffer in a collision than speed.

Multiple scientific studies involving the auto industry’s most advanced collisions dummies have shown that even minute reductions in the rate of speed can result in a significant reduction in the amount of trauma suffered by the victim. While a significant portion of victims struck by vehicles traveling 40 miles per hour or slower survive, those struck by vehicles traveling at faster speeds are almost always killed.

Thankfully, studies show that 95% of pedestrian collisions involve speeds of no more than 60 KMH (Roughly 37 MPH). However, most pedestrian accidents involve speeds between 15 and 35 MPH and result in what one study’s author called “severe damage.”

The Effect of Angle of Impact

As mentioned above, the angle of impact has a tremendous effect on the severity of pedestrian brain injury in victims hit by cars. The study mentioned previously actually used crash test dummies to recreate various types of pedestrian collisions including:

  • ​Front-facing

  • ​Back to

  • ​Side collisions

Each dummy was struck multiple times at various speeds in these various positions. While the amount of trauma inflicted on the virtual brain inside the mannequins was nearly identical at higher speeds, slower speed collisions showed marked differences.

Indeed, researchers found that pedestrians who struck from behind—even at the slowest collisions speed of 25 KMH (or roughly 15 miles per hour) suffered significant head trauma and likely pedestrian accident brain injury. This is likely because the human body replicas folded over the bumper and grills of the automobiles tested and the back of the head regularly collided with the hood and windshield of the test vehicles.

Front-facing crashes at these slow speeds showed the least head trauma (with the most damage to the face rather than the brain) while side-on collisions showed slightly more.

Any head trauma can be severe and certainly facial trauma is often disfiguring but, as brain trauma is often debilitating or fatal, it’s clear from these results that being struck from behind is a victim’s worst chance at surviving.

Who Is Most at Risk for Pedestrian Accident Brain Injury after Being Hit by a Car?

As you might expect, those same scientific studies show that a person’s bodily dimensions have a significant effect on the likelihood of the victim suffering a brain injury at the time of impact. While a person of average height might fare better in a collision, a shorter person’s head might contact the front (bumper or grill area) of the car. Additionally, a taller than average person might “fold” over the hood of a car, bringing their head into contact with the hood or windshield.

That’s part of the reason why children often suffer severe pedestrian brain injury after being hit by a car. Sadly, young folks are also the ones most likely to be hit by cars while walking in California. Roughly one-third of children 14 and younger killed in all traffic crashes throughout the country were on foot at the time of the collision. In addition, pedestrians between 10 and 15 years of age have the highest rates of non-fatal pedestrian injuries in The United States.

Types of Pedestrian Brain Injuries Seen in ERs on Victims Hit by Car

The five most common pedestrian accident brain injuries suffered by victims hit by cars are:


Concussions occur when the brain bounces around inside the skull and often involves two impacts—the primary impact as the head jerks in one direction than the secondary impact as it rebounds in the opposite direction. However, concussion may occur without the head actually striking anything.

Symptoms of concussion include:

The most common treatment for minor concussions is pain management during the healing process.

While concussions are generally regarded as the mildest form of TBI, they can lead to serious long-term


Contusions are essentially bruises on the brain. The force of an impact can often break blood vessels in or on the brain leading to bleeding. Many contusions are minor and will heal themselves. However, one risk is that the bruising will actually increase the pressure inside the skull, blocking blood flow to various parts of the brain. In such cases, victims may undergo surgical procedures.

Diffuse Axonal Injury

DAI (as it’s often called) occurs when the force exerted on the brain during pedestrian collisions with a car actually stretch the tissue of the brain itself. This can increase the distance between axons (brain cells) and decrease their ability to effectively communicate—leading to a host of problems from speech and motor control issues to Persistent Vegetative States.

Traumatic Subarachnoid Hemorrhage

This happens when blood leaks into the void in the skull filled with cerebral fluid. This can cause severe damage and quickly result in death or permanent brain damage. Treatment options for Traumatic Subarachnoid Hemorrhage are limited. Between 25% and 78% of victims will not survive treatment or will end up in vegetative states. An additional 12% of victims who do survive treatment will suffer life-long disabilities.


Hematomas are essentially blood clots caused by the initial trauma of a pedestrian brain injury. When hit by a car, victims often either come into contact with the vehicle or the roadway. This impact can easily tear delicate blood vessels in the brain. These clots could remain the same size or may grow, increasing pressure inside the skull. Some hematomas heal without surgical intervention but many require surgical procedures to relieve pressure inside the skull.

How the Severity of Pedestrian Brain Injury is Measured

Pedestrian accident brain injuries sustained after a victim has been hit by a car are often rated right at the crash scene as EMTs are stabilizing the pedestrian. The most common scoring system used in The United States is the Glasgow Coma Scale or GCS. This numbered scale is used to measure the depth of coma but can give EMTs a ballpark estimate of how badly a person’s brain has been injured in a crash when they don’t have other assets (such as medical imaging) available to them.

The GCS rates three aspects of functioning:

  • ​Eye opening

  • ​Movement

  • ​Verbal response

What do certain Glasgow Coma Scale numbers mean?

  • A GCS score of 3 indicates the deepest level of coma. Typically such a victim is completely unresponsive and even their autonomic systems (such as the irises’ response to light) don’t work.

  • A score of 9 or more indicates that the person is no longer considered to be in a coma but is not fully alert.

  • The highest score of 15 refers to a person who is fully conscious.

The Glasgow Coma Score is a quick and easy tool EMTs can use to triage pedestrian accident brain injury victims, but it isn’t as reliable as testing that can be done in the hospital. For example, a person could score a 15—fully alert and awake—but have still suffered tearing of the blood vessels in the brain. That internal bleeding may take hours to manifest visible physical symptoms. That’s why it’s absolutely essential that every victim struck by careless, reckless, or negligent drivers seek medical attention as soon as they can. Medical imaging is truly the only way to see what’s really going on in the brain.

Pedestrian Accident Brain Injuries Can Be Extremely Costly

The dollar amount associated with recovering from mild to moderate brain injury can be staggering. Adding up the cost of emergency medical treatment, surgical procedures, and therapy after the fact can bankrupt families even when they have health insurance.

For example:

  • The average ER visit runs around $1,200. That’s just to get in the door, not to run any tests.

  • The average single day’s admission into a hospital can be many times that (depending on your location).

  • A single MRI (Magnetic Resonance Imaging used to look at the soft tissue in the brain) is $2,600.

When you figure that the average hospital stay for a person who has suffered a brain injury is 5 days, you’re looking at a base bill of at least $5,000 if you DON’T have to stay overnight at the hospital. And that’s the best case scenario.

If the victim needs extended physical therapy (at between $50 and $350 per session), additional surgical procedures (several thousand dollars apiece), and an extended hospital stay, that figure could easily triple.

In fact, some researchers claim that the average cost for a relatively minor brain injury is just shy of $90,000 here in The United States. “Moderate” brain injuries can result in medical bills just under $1 million.

If you don’t have insurance or your policy doesn’t cover that sort of expense, you could be stuck trying to pay that massive bill yourself.

Getting Compensation for Pedestrian Accident Brain Injuries

Thankfully, many pedestrian brain injury victims have legal recourse available to them in order to seek compensation for those losses. Under California law, victims of reckless, negligent, or unlawful drivers have the ability to seek compensation from either the driver or that individual’s insurance company. In some cases, victims can even file claims with both their own insurance and the at-fault driver’s.

In order to successfully make such a claim, it may be necessary to prove that the driver was indeed at fault for your injuries. You may need to demonstrate negligence, carelessness, or recklessness in order to prove your case. This could be as simple as snapping a photo of the crosswalk you were in when you were hit or as involved as digging through mountains of evidence, tracking down eyewitness statements, and re-examining police reports.

Thankfully, California’s traffic laws are written with the onus to protect pedestrians squarely placed on the shoulders of drivers. However, it may still be in your best interest to hire a good personal injury attorney to protect your rights and get you a full and fair settlement.