Perioperative Challenges in Clinical Care and Management of Moderate and Sever Traumatic Brain Injury Patients

Background: Traumatic brain injury is a leading global health burden, where operative intervention is often required for moderate to severe categories. The perioperative period is very critical, with hypotension, hypoxia, and intracranial hypertension due to secondary insults worsening the outcomes. The common perioperative challenges in the surgery of TBI patients were identified, and their impact on clinical outcomes was assessed.Methods: A retrospective study will be performed at Menoufia University Hospital and Shebin El Kom Teaching Hospital between July 2023 and December 2024. All patients with moderate (GCS 9–12) or severe TBI (GCS ≤8) who underwent surgical intervention within 24 hours of injury will be included. All perioperative difficulties were noted. Outcomes will be measured by using GOS, length of ICU and hospital stay, and mortality. Results: fifty patients were included, with a mean age of 31.5 ± 23.2 years; 58% were male. The most frequent cause was road traffic accidents (46%), with predominating subdural and epidural hematomas. Intraoperative hypotension and hypoxia occurred in 56% and 28% of cases, respectively. Postoperative complications included seizures (16%), chest infections (12%), and rebleeding (6%). The mean ICU and hospital stays were 9.3 ± 6.7 and 16.4 ± 8.0 days, respectively. At the time of discharge, 38% had a good recovery (GOS 5), while overall mortality was 30%.Conclusion: Perioperative challenges in moderate and severe TBI result in significant impacts on patient outcomes. Protocol-based management, vigilant intraoperative care, and early intervention are quite crucial for improving recovery and reducing mortality in operative TBI patients.