الفهرس 
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Abstract
Head trauma patients are usually at a great risk of developing secO ndary bra in injury, w hi ch is mainly m ed iated by cerebral ischemia and/or hypoxemia. A fter severe traumatic brain injury (TBI) secondary ischemic neurologic damage associated with post in.jury hypotension, hypoxemi”, and intracranial hypertension contribute to
adverse outcome. Cerebral vasoconstriction and impaired pressure autoregulation are the potential mechanisms leading to’ secondary ischemic brain damage. TBl initiates a cascade of potentially harmful biochemical changes. Intracellular calcium shifts, free oxygen radicals and vasoactive arachidonic acid metabolites are released damaging vascular endothelium and neuronal membranes. In addition, levels of excitatory amino acids, such as glutamate and aspartate, increase in proportion to the severity of brain injury and correlate with redueed
a vaila b iii t Y 0 f hi gh .energy p hos pha te eo rn po u nds. There fore a vari ety of agents have been used as a brain protectants in patients with head trauma to alter these biochemical events in case of ischemia and brain injury. One of the most commonly used agent is thiopentone sodium infusion that exert its protective effect due to its ability to reduce the cerebral metabolic rate of oxygen (CMR02), thus improving the ratio of oxygen supply to oxygen demand, reduce elevated lCP that is refractory to hyperventil8tion 8nclmannitol, v8soconstriction in areas of healthy brain that shunts cerebral blood now to injured areas, reduce calcium in nux, inhibit free radical (on11(ltion, potentiatc GAGA ergic activity, reduce cerebral oedema, inhibit glucose transfer across the blood-brain barrier, enhance cyclic AMP production, block Na channels ami reduces NIVIDA that induce neuronal damage by blockade ofNMDA receptors. The study was conducted to assess the brain protective effect of thiopentone sdium in fusion in head trauma patients admittcd at the Mansoura Emergency Hospital in the last 2 years. The study included 118 patients suffering lrom head trauma. According to GCS and age, patients were divided into either thiopentone sodium group, or the control group which were not given thiopentone sodium. The thiopentone group included 47 patients and the control group included 71 patients. There were improved outcome and signi ficant increase in survival in the thiopentone group in comparison to the control group .