الفهرس 
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Abstract
Trauma is the third leading cause of death overall and the leading cause of death among those aged 1–44 years. TBI is a major public health Problem due to the fact that each year, an estimated 1.5 million people sustain head injury in the United States.
The devastating consequences of head injury have been recorded since ancient times early neurosurgical records were primarily observational, with very few suggestions for treatment. Despite centuries of investigation and the development of new and better intensive care, we still have not discovered effective therapies that can be applied after the injury to reverse most pathologic aspects of traumatic brain injury
Researches aiming at reducing or preventing the neurological consequences of head trauma are ongoing, but currently the clinical outcome following TBI depends on the circumstances of injury and early clinical management aiming at reducing the occurrence of secondary brain insults. No effective intervention has been found to reverse the pathologic events initiated by the traumatic event.
Secondary brain injury from progressive intracranial bleeding, cerebral edema, increased intracranial pressure, and subsequent cerebral ischemia is the primary cause of morbidity and mortality after TBI. Secondary brain injury is worsened by posttraumatic coagulopathy, which occurs in a third of brain injured patients and is associated with a 10-fold increase in risk of death.
Recently, the antifibrinolytic agent tranexamic acid (TXA) demonstrated improved mortality compared with placebo in severely bleeding trauma patients in the CRASH-2 trial, which enrolled 20211 patients in 40 countries. In addition to the robust data demonstrating clinical benefit in trauma patients with severe bleeding, TXA also has an excellent safety profile and has been shown to be cost-effective. Because of the mechanistic potential for TXA to decrease secondary brain injury, it has been considered as a possible therapy to improve clinically important outcomes in patients with TBI.
The study was conducted on 100 patients with traumatic brain injury admitted to Emergency Department of Alexandria Main University Hospital. This study includes isolated traumatic brain injured patients. Patients with pediatrics and infants age groups, with known hypersensitivity to TXA, and with thromboembolic history were excluded from study.
The aim of the work is to evaluate the effect of Tranexamic acid on volume changes of intracranial bleeding in patients with TBI admitted to Surgical Emergency department.
Primary and secondary survey done for cases on admission, this also include lab tests and CT brain that asses brain findings on admission. Multiple CT finding is more common than single CT finding.
Tranexamic acid has been used to prevent increase in size of intracranial hemorrhage in this study as it has the greatest amount of data supporting its use in trauma patients.
Patients given tranexamic acid compared to controls had significantly decreased size of hemorrhage in patients with traumatic brain injury but there is no significance decrease in mortality.