Traumatic brain injury is a leading cause of mortality and long-term disability worldwide, especially in low- and middle-income countries. Neurosurgical intervention plays a critical role in mitigating secondary brain injury and improving outcomes in moderate to severe Traumatic brain injury cases. However, significant variability persists in surgical strategies, timing, and intraoperative adjuncts, necessitating comprehensive outcome-based evaluations. This study aims to assess the outcomes of neurosurgical interventions in moderate to severe Traumatic brain injury, with particular focus on the type and timing of surgery, postoperative complications, and the impact of intracranial pressure monitoring on recovery. A prospective observational study was conducted on 108 Traumatic brain injury patients undergoing surgery. Demographic data, surgical details, and postoperative outcomes were recorded. Functional outcomes were assessed using the Glasgow Outcome Scale at 3 months. The subgroup comparison was done on timing of surgery, type of procedure and intracranial pressure monitoring. The favorable Glasgow Outcome Scale result was reported in patients who received early surgical intervention (<6 hours) more than who did not (64.7%). The decompressive craniectomy had higher recovery rates (62.7%) in comparison to the craniotomy or hematoma evacuation. The intracranial pressure monitored the patients and their outcomes were better with minimal complications. The total postoperative complication rate was 25.9% and most frequent were rebleeding and infection. Early neurosurgery and intraoperative monitoring is related to better short-term functional outcomes among the Traumatic brain injury patients. In future, the research needs to be standardized regarding treatment procedures and consider minimally invasive and neuroprotective approaches.

Traumatic brain injury, Neurosurgery, Decompressive craniectomy, Surgical timing, Intracranial pressure monitoring, Postoperative complications.