On any given day, Montreal’s bike paths are full but helmets are noticeably absent.

It might seem obvious that bike helmets can save lives, but many cyclists have a host of reasons to avoid wearing them.

One Montreal doctor says there are far more important reasons to wear them.

“Frontal lobe hits are hits that could affect reason, judgment, concentration, attention (and) memory,” says Dr. Jehane Dagher.

Dagher, who specializes in traumatic brain injuries, worked on a study that found helmets save lives, and she has studied more than one hundred cyclists who were hospitalized after accidents. In all cases, helmets made a huge difference.

“The ones who did not wear a helmet stayed six times longer in the intensive care unit and they had more significant bleeds and therefore had to be sent to rehab instead of going home directly,” she said.

Jeremy Benezra's life changed four years ago. As he was crossing Decarie Blvd. on a red light, a car hit the back wheel of his bike.

He said he flew “three metres in the sky. They said to my mom 'like a butterfly, he was like a butterfly.’”

Benezra, 21, was not wearing a helmet. He suffered a severe brain injury with massive bleeding. He spent more than six months in hospital and rehab.

The Quebec Association for Cyclists says helmets have limited efficiency. According to the group, traffic laws and road infrastructure are more important factors for bike safety.

Marc Jolicoeur, Velo Quebec’s research director, echoed that opinion, saying instead of a mandatory helmet law, traffic-calming measures would be a better solution.

“If traffic is going slowly, usually there is no problem,” he said.

But Dr. Dhager disagrees and says she hopes other trauma centres will release their own findings and help propel change, because she says the numbers speak for themselves.

Benezra still gets headaches, dizziness, and recently has begun having problems with his motor skills.

His mother, Vicky, who was the first person he saw when he woke from his coma, told him he had to wear full-body protection if he wanted to ride a bike again.

He tried it once, but still isn’t interested in wearing a helmet, and so he doesn’t ride bikes anymore.

“I won’t push myself. If I have another brain injury, I could face death,” he said.