Role of Computed Tomography in Craniocerebral Trauma

Background: Traumatic brain injury (TBI) remains a signicant cause of morbidity and mortality worldwide, especially in low- and middle-income countries. With the rise in road trafc accidents (RTAs), TBI incidence is increasing, affecting predominantly young and middle-aged individuals. Early diagnosis using clinical and radiological tools is essential for effective management and outcome prediction. This study aimed to evaluate the clinical presentations, CT imaging ndings, and Glasgow Coma Scale (GCS) scores in TBI patients, and to assess their prognostic value, particularly the impact of midline shift on outcomes. Materials And Methods: A prospective observational study was conducted at the Department of Radiodiagnosis, Sri Aurobindo Medical College & PG Institute, Indore, over 18 months. Two hundred patients with head trauma who underwent CT imaging were included. Data regarding demographics, clinical features, GCS scores, and CT ndings were analyzed. Associations between midline shift, GCS, and outcomes were assessed using statistical tests. Results: Most patients were males (80%) aged 31–50 years. RTAs were the most common cause (59.5%). Frequent CT abnormalities included skull fractures (42%), cerebral edema (38%), and epidural hemorrhage (35%). A strong negative correlation was observed between GCS scores and midline shift (r = –0.800; p < 0.001). Severe midline shift (>5 mm), low GCS, and diffuse axonal injury were signicantly associated with poor outcomes and higher mortality. Conclusion: GCS scores and CT-based parameters, especially midline shift and diffuse axonal injury, are critical prognostic indicators in TBI. Early clinical and radiological assessment can optimize management and improve patient outcomes.