Cathy Vansteenburg looks at her blood-streaked and cracked bicycle helmet with great appreciation. It saved her life, she says.

Vansteenburg was wearing the white helmet while riding home from work in the dark on May 30 when she was hit head-on by another bicyclist who was on the wrong side of the road. The collision near Hwy. 10 and 171st Street in Elk River landed Vansteenburg in the critical care unit at Mercy Hospital, where she was treated for injuries that included broken bones, deep lacerations to her face and eyes, and a nose that was pushed up into the sinus cavity.

In the weeks following, she could not read the newspaper without a magnifying glass. She went to therapy three times a week, but often could not remember it. She still has no sense of taste or smell, and might not get them back.

Still, Vansteenburg looks at her mangled helmet and is thankful that it absorbed the brunt of the impact when she hit the pavement.

"That is what would have happened to my head," she said recently. "People need to know what a bop on the head can do. If I had not been wearing it, I'd not be alive."

Helmets might not be the most fashionable accessory, and some cyclists don't use them because they can do a number on a hairdo, said Julie Philbrook, a trauma prevention specialist at Hennepin County Medical Center in Minneapolis. But for as little as $20, helmets are inexpensive insurance against debilitating injuries or death.

She said wearing a helmet can reduce the chances of sustaining a head injury by 85 percent and a brain injury by 88 percent.

"Helmets make a huge difference in the patients we see here," Philbrook said. "If you have a brain injury, we are going to shave your hair off anyway."

Bicycling is one of the most popular forms of recreation in the United States, with 73 to 85 million people on two-wheelers. It's also dangerous. Head injuries account for 500 of the 800 bicycling deaths reported annually, the National Safety Council said.

Helmets not mandated

There is no state law that requires cyclists to wear helmets, but they are mandatory in some cities, such as Seattle. Nationwide, only about 45 percent of children under 14 wear helmets, according to Safe Kids Worldwide, an organization dedicated to preventing injuries in children.

Adults are not much better, even though wearing a helmet is "the single most effective safety device available to reduce head injury and death from bicycle crashes," it said.

In 2013, HCMC treated 88 people for head injuries related to bicycling. Only 26 were wearing helmets. Those who were helmetless were more than two times as likely to suffer a traumatic brain injuries than those who wore them, Philbrook said.

"We put six feet of wood chips on playgrounds to project children to take the impact from falling away," Philbrook said.

"The helmet is doing the same thing. It takes the impact and disseminates the force before it can get to the brain."

Helmets should meet U.S. Consumer Product Safety Commission standards. Philbrook says helmets should sit flat and level on the head, and should be worn low, about two fingers above the eyebrows, not on the forehead. It should be snug, but not uncomfortable, she said.

Said Vansteenburg "Put on a darn helmet. If you value life, wear a helmet."