Traumatic brain injury results from external mechanical force causing disruption of normal brain function and may range from mild concussive injury to severe, life-threatening brain damage. It is a major cause of mortality and long-term disability, with neurosurgical involvement critical in moderate to severe cases. Injury mechanisms include blunt trauma, acceleration–deceleration forces, and penetrating injury.

Clinical presentation varies widely and depends on injury severity and location. Patients may present with loss of consciousness, altered mental status, focal neurological deficits, seizures, or signs of raised intracranial pressure. Secondary brain injury due to cerebral edema, hypoxia, or hypotension significantly influences outcome and must be actively prevented.

Neurosurgical evaluation begins with rapid neurological assessment and urgent neuroimaging. Computed tomography is the primary diagnostic tool for identifying intracranial hemorrhage, mass effect, skull fractures, and brain swelling. Serial imaging may be required to monitor injury evolution.

Surgical intervention is indicated in selected cases to evacuate hematomas, decompress the brain, and control intracranial pressure. Procedures are aimed at preventing secondary injury and preserving viable brain tissue. Decision-making is guided by neurological status, imaging findings, and physiological parameters.

Postoperative and intensive care management is integral to TBI treatment. Close monitoring of neurological status, intracranial pressure, and systemic physiology is essential. Rehabilitation planning begins early to optimize recovery potential.

Traumatic brain injury management requires coordinated neurosurgical and critical care expertise, with timely surgical intervention playing a decisive role in survival and neurological outcome.