SPECTRUM OF NEUROSURGICAL TRAUMATIC BRAIN INJURY ADMISSIONS: AGE-SEX PROFILE, TREATMENT PATTERNS, AND OUTCOMES AT A TERTIARY-CARE HOSPITAL

Abstract

Traumatic brain injury (TBI) constitutes a major proportion of neurosurgical admissions. We aimed to describe the diagnostic spectrum of neurosurgical head injury admissions within the TBI spectrum, along with the age-sex profile, treatment patterns, and short-term neurologic outcomes at discharge in a tertiary neurosurgical referral center in India. We retrospectively reviewed all neurosurgical head injury admissions at a single tertiary-care center between April 2022 and April 2024 (n = 158). Included cases comprised neuroimaging-confirmed TBI or neurosurgically relevant head trauma admitted under neurosurgery. Each case was assigned to one mutually exclusive primary diagnostic category based on the dominant clinically significant lesion or primary injury. Descriptive statistics were used; continuous variables are presented as mean ± standard deviation and categorical variables as frequencies and percentages. Of the 158 patients, 77.2% were male, with a mean age of 34 years. Extra-axial hematomas were the most common diagnosis (37.3%), followed by skull fractures (29.7%), minor head injury or soft-tissue injuries (13.9%), parenchymal brain injuries (12.0%), and polytrauma-related TBI (7.0%). Overall, 57.0% of patients were managed conservatively and 43.0% underwent surgical intervention. Severe outcomes were most frequent among patients with polytrauma-related TBI (45.5%). Focal hemorrhagic TBIs, particularly acute subdural hematomas, predominated in this tertiary-care cohort and accounted for much of the operative workload. Poorer short-term outcomes among surgically treated patients likely reflect greater initial injury severity rather than adverse effects of surgery itself.