Analytical Study of Cranial Trauma Patterns and Neurosurgical Outcomes at Federal Medical Centre, Owerri, South East Nigeria

Traumatic brain injury is a leading cause of mortality and long-term disability in Nigeria, and the pattern of cranial trauma and the quality of neurosurgical outcomes at secondary and federal medical centres in South East states are inadequately characterised. This study analytically examines the injury patterns, computed tomography findings, neurosurgical management, and outcomes of cranial trauma cases at Federal Medical Centre, Owerri, Imo State. A retrospective cohort design is applied to emergency and neurosurgery records of 280 cranial trauma patients admitted between 2019 and 2023. Variables include GCS score at admission, injury mechanism, CT brain classification using the Marshall CT Grading System, surgical intervention type, intracranial pressure management, ICU duration, and Glasgow Outcome Scale at 90 days. Multivariable logistic regression in SPSS identifies predictors of unfavourable outcome. Available neurological trauma literature from South East Nigeria identifies road traffic crashes as the dominant mechanism in over 65 percent of cranial trauma admissions, with GCS below 8 at admission and Marshall CT grade IV or V as the strongest predictors of in-hospital mortality. The ATLS management framework and Glasgow Outcome Scale provide clinical and outcome classification references. Findings will support the Federal Medical Centre in developing a structured cranial trauma pathway and advocating for dedicated neurosurgical ICU capacity. Keywords: traumatic brain injury, cranial trauma, neurosurgical outcomes, Owerri, South East Nigeria.