A sizeable proportion of adult pedestrians involved in vehicle-versus-pedestrian accidents suffer head injuries, some of which can lead to lifelong disability or even death. To understand head injury mechanisms, in-depth accident analyses and accident reconstructions were conducted. A total of 120 adult pedestrian accident cases from the GIDAS (German in-depth accident study) database were analyzed, from which 10 were selected for reconstruction. Accident reconstructions initially were performed using multi-body system (MBS) pedestrian and car models, so as to calculate head impact conditions, like head impact velocity, head position and head orientation. These impact conditions then were used to set the initial conditions in a simulation of a head striking a windshield, using finite element (FE) head and windshield models. The intracranial pressure and stress distributions of the FE head model were calculated and correlated with injury outcomes. Accident analysis revealed that the windshield and its surrounding frames were the main sources of head injury for adult pedestrians. Reconstruction results indicated that coup/contrecoup pressure, Von Mises and shear stress were important physical parameters to estimate brain injury risks.