E-scooters are zipping through 133 U.S. cities and sales are projected to nearly double by 2031 — but a new study in Scientific Reports is raising serious red flags about brain safety. Analyzing data from England and Wales' National Major Trauma Registry (2020–2022), researchers found that traumatic brain injuries (TBI) accounted for roughly 36 out of every 100 moderate-to-severe e-scooter incidents. Adult e-scooter riders were 3.45x more likely than motorcyclists and 1.74x more likely than cyclists to sustain a TBI — a gap experts attribute largely to the vehicle's high center of gravity and near-zero helmet use.

Neurologist Dr. Korak Sarkar of Ochsner Health emphasizes that the findings aren't surprising, but they are significant. The injury profile is distinct: e-scooter riders have lower fracture risk than motorcyclists, but far higher head and abdominal injury risk — the injuries most likely to cause long-term disability. Children are disproportionately affected, representing 16% of e-scooter trauma patients, roughly double their share among cyclists and motorcyclists.

Key Takeaways:

• Only ~6% of e-scooter riders wore helmets vs. 76% of motorcyclists and 45% of cyclists — the most modifiable risk factor
• Children riding e-scooters had 2.39x the TBI risk of child motorcyclists and 1.38x that of child cyclists
• Fewer than 10% of serious e-scooter injuries are captured in national statistics due to inconsistent coding
• Clinicians should routinely ask about micromobility use, counsel on helmet use, and document injury mechanism to improve surveillance

Why it matters: With e-scooter use rapidly expanding, the healthcare system is flying blind — under 10% of serious injuries are captured in national data. Better injury coding, helmet mandates paired with helmet availability at docking stations, and infrastructure improvements could meaningfully reduce a growing burden of preventable brain injury.