Abstract
Severe traumatic brain injury (sTBI) is a significant public health concern with high disability and mortality rates. No reliable diagnostic tools exist to determine surgical indications or predict prognosis. To assess the clinical value of computed tomography angiography (CTA) and perfusion (CTP) in sTBI, and compare treatment efficacy based on traditional imaging versus CTA/CTP assessment. This retrospective study included 169 patients with sTBI who underwent CTA/CTP at admission and postoperatively to guide treatment decisions. Another 132 patients received treatment based on traditional imaging. Clinical outcomes and complications were compared between the two groups. Baseline characteristics did not differ significantly between groups. Although the 6-month Glasgow outcome scale (GOS) scores were comparable, in-hospital mortality was lower in the CTA/CTP group, and the craniotomy rate was significantly reduced. A higher proportion of patients who underwent the operation in the CTA/CTP group had favorable prognoses. Moreover, the hospitalization duration and costs were substantially lower in the CTA/CTP group. The CTA/CTP imaging provides critical cerebrovascular and perfusion data in sTBI, aiding in surgical decision-making and perioperative management.