Pattern of computed tomography findings among acute traumatic brain injury patients at a tertiary institution in southwestern Nigeria

Background: Head injury (HI) also regarded as traumatic brain injury (TBI) constitutes injury that occurs to the brain as a result of trauma. It remains a significant cause of morbidity and mortality globally, particularly in low-and middle-income countries like Nigeria. It is thought to be a varied, dynamic pathophysiological process that begins at the point of impact and goes on throughout time, with consequences possibly manifesting years after the original incidence. However, there is paucity of local data describing CT finding in patients with acute TBI in southwestern Nigeria within the last ten years. This study aims to determine the incidence of the findings in head-injured patients who underwent cranial CT imaging and to describe the common CT findings among these patients. Methods: This retrospective study reviewed the CT scan and medical records of adult patients (≥ 18years) who presented with acute head injury and underwent non-contrast CT scan at a tertiary teaching Hospital in southwestern Nigeria between January 2021 and December 2023. The CT findings documented were skull fractures, hemorrhages, brain contusion, brain oedema. Midline shift and other intracranial abnormalities. Data collected were analyzed using IBM SPSS Statistics (Version 27). Descriptive and inferential statistics were used, with significance set at p  < 0.05. Results: A total of 466 patients were included, with a male-to-female ratio of approximately 3:1. The median age was 35 years (IQR 23–48). The most frequently observed CT finding were skull fractures (35.4%), followed by cerebral edema (32.2%) and brain contusions (27.3%). Subdural and epidural hematomas were seen in 11.8% and 9.9% of cases, respectively. Cerebral edema and contusions showed a strong positive correlation ( r  = 0.868). Males had significantly higher rates of skull fractures (p = 0.001), contusions (p = 0.007), and edema (p = 0.014). Subdural hematomas with associated midline shifts were more common among older patients (p = 0.019 and 0.005, respectively). Conclusion: In this study involving patients with acute TBI, the most common CT findings were skull fractures, cerebral edema, and contusions. The significant correlation between certain injury patterns underscores the importance of timely CT evaluation, particularly in older adults and in cases of high-impact trauma. These findings highlight the need for imaging protocols that support early diagnosis and tailored management of TBI in our region