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Head-on collisions are the most serious type of car accident. They take place when the front ends of two vehicles collide, and the force of such a collision is greater when a passenger vehicle is hit by a truck or tractor-trailer. Even those that take place at slower speeds can be catastrophic, and according to the National Cooperative Research Program, head-on crashes are more common in rural areas. This is because driving on undivided two-lane roads is more dangerous. Common Causes Common causes of head-on collisions include: Driving under the influence.