Everytime I have spilled (always unexpected and freak accidents).. My head has inevitably collided with the ground - or pavement... I hate wearing them yet I enjoy having my brain intact.
My pet hate is the wearing of helmets perched on the back of the head and not fastened tightly under the chin. If you have gone to the expense and minor miscomfort of using a helmet, you really should get as much protection as possible. I'm also amazed at the number of kids I see cycling to school with the helmets their parents have insisted they wear when they set off, dangling from their handlebars.