{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T17:48:40Z","timestamp":1772560120992,"version":"3.50.1"},"reference-count":23,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T00:00:00Z","timestamp":1665532800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>We report the case of a 54-year-old man who died in a motorcycle accident due to loss of control of the vehicle on a viaduct. No other vehicles were apparently involved, except for a car hit by the motorcycle after it fell. A post-mortem CT scan (computed tomography scan) was performed showing complex head trauma with a subarachnoid hemorrhage and multiple skull and facial bone fractures. A forensic cinematic reconstruction performed by an engineer was needed to exclude other incident causes other than the loss of control. The multidisciplinary approach that included autopsy findings, a cinematic reconstruction, a helmet test and an examination played a key role in clarifying the dynamics of the accident, allowing us to explain how the death occurred despite the motorcyclist\u2019s helmet use. The cause of death was identified as a penetrating head trauma with cerebral material exposure, produced by the impact of the head against a fixed bolt in the guardrail base. Despite the use of the helmet, the impact force was enough to render the protection ineffective and allowed the bolt to penetrate through the helmet and the skull.<\/jats:p>","DOI":"10.3390\/diagnostics12102465","type":"journal-article","created":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T05:31:18Z","timestamp":1665552678000},"page":"2465","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["When the Helmet Is Not Enough: Forensic Multidisciplinary Reconstruction of a Deadly Motorcycle Accident"],"prefix":"10.3390","volume":"12","author":[{"given":"Antonio Maria","family":"Catena","sequence":"first","affiliation":[{"name":"Institute of Legal Medicine, University of Rome 2 \u201c<i>Tor Vergata<\/i>\u201d, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9434-2604","authenticated-orcid":false,"given":"Michele","family":"Treglia","sequence":"additional","affiliation":[{"name":"Institute of Legal Medicine, University of Rome 2 \u201c<i>Tor Vergata<\/i>\u201d, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi Tonino","family":"Marsella","sequence":"additional","affiliation":[{"name":"Institute of Legal Medicine, University of Rome 2 \u201c<i>Tor Vergata<\/i>\u201d, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0840-825X","authenticated-orcid":false,"given":"Marcello","family":"Locatelli","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Chieti-Pescara \u201c<i>G. d\u2019Annunzio<\/i>\u201d, Via dei Vestini 31, 66100 Chieti, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrica","family":"Rosato","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Chieti-Pescara \u201c<i>G. d\u2019Annunzio<\/i>\u201d, Via dei Vestini 31, 66100 Chieti, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3740-8857","authenticated-orcid":false,"given":"Abuzar","family":"Kabir","sequence":"additional","affiliation":[{"name":"International Forensic Research Institute, Department of Chemistry and Biochemistry, Florida International University, Miami, FL 33199, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Bonelli","sequence":"additional","affiliation":[{"name":"Department of Legal Medicine, University of Chieti-Pescara \u201c<i>G. d\u2019Annunzio<\/i>\u201d; 66100 Chieti, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristian","family":"D\u2019Ovidio","sequence":"additional","affiliation":[{"name":"Department of Legal Medicine, University of Chieti-Pescara \u201c<i>G. d\u2019Annunzio<\/i>\u201d; 66100 Chieti, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.jsr.2020.12.015","article-title":"Investigation of Accidents Involving Powered Two Wheelers and Bicycles \u2013 A European in-Depth Study","volume":"76","author":"Brown","year":"2021","journal-title":"J. Saf. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s13017-020-00297-1","article-title":"Motorcycle-Related Trauma:Effects of Age and Site of Injuries on Mortality. A Single-Center, Retrospective Study","volume":"15","author":"Granieri","year":"2020","journal-title":"World J. Emerg. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2946","DOI":"10.1016\/j.injury.2020.09.025","article-title":"Severe Traffic Injuries in the Helsinki Trauma Registry between 2009\u20132018","volume":"51","author":"Airaksinen","year":"2020","journal-title":"Injury"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1111\/j.1742-6723.2010.01337.x","article-title":"Motorcycle-Related Major Trauma: On-Road versus off-Road Incidence and Profile of Cases","volume":"22","author":"Gabbe","year":"2010","journal-title":"EMA\u2014Emerg. Med. Aust."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1016\/j.amjsurg.2018.10.007","article-title":"The Danger Zone: Injuries and Conditions Associated with Immediately Fatal Motorcycle Crashes in the State of Michigan","volume":"217","author":"Saunders","year":"2019","journal-title":"Am. J. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1097\/TA.0000000000002861","article-title":"Impact of Helmet Laws on Motorcycle Crash Mortality Rates","volume":"89","author":"Notrica","year":"2020","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1208","DOI":"10.1056\/NEJMp1615621","article-title":"Motorcycle-Helmet Laws and Public Health","volume":"376","author":"Busko","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1016\/j.amepre.2016.11.030","article-title":"Universal Motorcycle Helmet Laws to Reduce Injuries: A Community Guide Systematic Review","volume":"52","author":"Peng","year":"2017","journal-title":"Am. J. Prev. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1080\/15389588.2021.1894640","article-title":"Motorcycle Helmet Selection and Usage for Improved Safety: A Systematic Review on the Protective Effects of Helmet Type and Fastening","volume":"22","author":"Lucci","year":"2021","journal-title":"Traffic Inj. Prev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1186\/s12889-017-4649-1","article-title":"The Protective Effect of Helmet Use in Motorcycle and Bicycle Accidents: A Propensity Score-Matched Study Based on a Trauma Registry System","volume":"17","author":"Kuo","year":"2017","journal-title":"BMC Public Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1097\/TA.0b013e3181f8a9cc","article-title":"An Evidence-Based Review: Helmet Efficacy to Reduce Head Injury and Mortality in Motorcycle Crashes: EAST Practice Management Guidelines","volume":"69","author":"MacLeod","year":"2010","journal-title":"J. Trauma\u2014Inj. Infect. Crit. Care"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.aap.2010.08.021","article-title":"Risk Factors for Injury Accidents among Moped and Motorcycle Riders","volume":"49","author":"Moskal","year":"2012","journal-title":"Accid. Anal. Prev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.jsr.2020.02.003","article-title":"Crash Risk Factors for Novice Motorcycle Riders","volume":"73","author":"Senserrick","year":"2020","journal-title":"J. Saf. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1111\/j.1556-4029.2010.01657.x","article-title":"Death by Motorcycle: Background, Behavioral, and Situational Correlates of Fatal Motorcycle Collisions","volume":"56","author":"Nunn","year":"2011","journal-title":"J. Forensic Sci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1080\/15389588.2017.1410145","article-title":"Risk Factors for Motorcycle Loss-of-Control Crashes","volume":"19","author":"Wu","year":"2018","journal-title":"Traffic Inj. Prev."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Liu, B.C., Ivers, R., Norton, R., Boufous, S., Blows, S., and Lo, S.K. (2008). Helmets for Preventing Injury in Motorcycle Riders. Cochrane Database Syst. Rev., CD004333.","DOI":"10.1002\/14651858.CD004333.pub3"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Choi, W.S., Cho, J.S., Jang, Y.S., Lim, Y.S., Yang, H.J., and Woo, J.H. (2020). Can Helmet Decrease Mortality of Craniocerebral Trauma Patients in a Motorcycle Accident?: A Propensity Score Matching. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0227691"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1080\/15389588.2016.1211271","article-title":"Differential Protective Effects of Motorcycle Helmets against Head Injury","volume":"18","author":"Singleton","year":"2017","journal-title":"Traffic Inj. Prev."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1016\/j.bjoms.2014.05.006","article-title":"Influence of Type of Helmet on Facial Trauma in Motorcycle Accidents","volume":"52","author":"Cini","year":"2014","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.aap.2015.10.004","article-title":"Motorcycle Helmet Type and the Risk of Head Injury and Neck Injury during Motorcycle Collisions in California","volume":"86","author":"Erhardt","year":"2016","journal-title":"Accid. Anal. Prev."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Lam, C., Wiratama, B.S., Chang, W.H., Chen, P.L., Chiu, W.T., Saleh, W., and Pai, C.W. (2020). Effect of Motorcycle Helmet Types on Head Injuries: Evidence from Eight Level-I Trauma Centres in Taiwan. BMC Public Health, 20.","DOI":"10.1186\/s12889-020-8191-1"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1302\/2058-5241.5.190090","article-title":"A Review of Common Motorcycle Collision Mechanisms of Injury","volume":"5","author":"Petit","year":"2020","journal-title":"EFORT Open Rev."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.mcna.2019.11.001","article-title":"Traumatic Brain Injury: An Overview of Epidemiology, Pathophysiology, and Medical Management","volume":"104","author":"Capizzi","year":"2020","journal-title":"Med. Clin. N. 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