Surgeon says he sees three children a month with cycling head injuries he believes would not have happened had they been wearing a helmet

Cycle helmets save lives says a consultant paediatric neurosurgeon from Bristol – just a fortnight after a brain surgeon in London said that there was no point in riders wearing “flimsy little helmets” to protect their heads.

Michael Carter of Bristol Children's Hospital says he treats an average of three children a month who have suffered a head injury while cycling that he believes would not have happened if they had been wearing a helmet, reports the Bristol Post.

His views conflict with those of Henry Marsh of St George’s Hospital in Tooting, South London, who as we reported last month said that helmets had not benefited patients in his care who had been involved in bike crashes.

Mr Marsh told the Hay Festival: “I ride a bike and I never wear a helmet. In the countries where bike helmets are compulsory there has been no reduction in bike injuries whatsoever.

“I see lots of people in bike accidents and these flimsy little helmets don’t help.”

He also cited research by Dr Ian Walker from the University of Bath who found that motorists gave less space to riders wearing helmets, because they perceived them as being safer than those without the headgear.

But Mr Carter insisted that the case against wearing helmets was “weak” and often founded on research that was small in sample size. He also said his experience at work contrasted with that of Mr Marsh.

In support of his views, he cited Cochrane Review studies which combine the results of a number of studies from around the world.

He said: "We get an enormous number of cycling accidents coming in here. The vast majority of head injuries seen are not life threatening. But often [they are] painful and disruptive and require inpatient treatment. Generally it's easy to see that they could have been reduced or prevented if they were wearing helmets."

Among criticisms levelled at Cochrane Reviews in the area of cycle helmets, however, is that they are not truly independent since some reviewers have focused on their own studies and discount others, and that they do not address rotational injuries.

Another concern expressed at some studies from jurisdictions where helmets are compulsory is that they fail to analyse any perceived drop in head injuries among cyclists in the context of reduced levels of riding bikes once people have become legally obliged to wear a helmet.

CTC and Sustrans both oppose compulsion in the UK because they believe the overall health benefits associated with cycling in relation to the population as a whole outweigh any reduction in the number of cyclists they believe would follow helmets being made mandatory.

Mr Carter cited one recent instance where a youngster was struck in the head by a wing mirror and he maintained that had they been wearing a helmet, they would have been uninjured.

The circumstances of the incident were not reported, so it is unclear whether the child rode into the car, or the vehicle struck the youngster, in which case the incident could perhaps have been avoided altogether had the driver given the cyclist more room.

Unlike Mr Marsh, who has been cycling for 40 years and sports a cowboy hat while on his bike, Mr Carter no longer rides one following three separate incidents last year in which two of his friends were seriously injured and another killed.

While some might see that decision as being one based on his individual experience, unfortunate as it is, rather than looking at the wider picture, he asserts that his home city is unsafe for bike riders.

"Bristol is advertised as a cycling friendly city,” he said. “But it's actually an old Victorian city with small narrow roadways and a large volume of traffic. The roads were never designed for motorists and cyclists to use together.

"Cycle paths are incomplete throughout the city and this poses a real risk to cycle traffic. Wearing a helmet is simple and cheap. It's a minor inconvenience that at worst might be uncomfortable on a hot day, but at best might save your life."

Born in Scotland, Simon moved to London aged seven and now lives in the Oxfordshire Cotswolds with his miniature schnauzer, Elodie. He fell in love with cycling one Saturday morning in 1994 while living in Italy when Milan-San Remo went past his front door. A daily cycle commuter in London back before riding to work started to boom, he's been news editor at road.cc since 2009. Handily for work, he speaks French and Italian. He doesn't get to ride his Colnago as often as he'd like, and freely admits he's much more adept at cooking than fettling with bikes.