Subarachnoid hemorrhage (SAH) is a subtype of stroke with high mortality and morbidity due to the lack of effective therapy. Atorvastatin has been reported to alleviate early brain injury (EBI) following subarachnoid hemorrhage (SAH) via reducing reactive oxygen species, antiapoptosis, regulated autophagy, and neuroinflammation. Which was the related to the pyroptosis? Pyroptosis can be defined as a highly specific inflammatory programmed cell death, distinct from classical apoptosis and necrosis. However, the precise role of pyroptosis in atorvastatin‐mediated neuroprotection following SAH has not been confirmed. The present study aimed to investigate the neuroprotection and potential molecular mechanisms of atorvastatin in the SAH‐induced EBI via regulating neural pyroptosis using the filament perforation model of SAH in male C57BL/6 mice, and the hemin‐induced neuron damage model in HT‐22. Atorvastatin or vehicle was administrated 2 h after SAH and hemin‐induced neuron damage. The mortality, neurological score, brain water content, and neuronal death were evaluated. The results show that the atorvastatin treatment markedly increased survival rate, neurological score, greater survival of neurons, downregulated the protein expression of NLRP1, cleaved caspase‐1, interleukin‐1β (IL‐1β), and IL‐18, which indicated that atorvastatin‐inhibited pyroptosis and neuroinflammation, ameliorated neuron death in vivo/vitro subjected to SAH. Taken together, this study demonstrates that atorvastatin improved the neurological outcome in rats and reduced the neuron death by against neural pyroptosis and neuroinflammation.

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AIm:The aim of this study was to investigate retrospectively the multiple injuries prone to be missed in 432 cases. mAterIAl and methOds:The cases were divided into two groups, i.e., whether the missed injury was found during admission or follow up. The mean ISS value, ratio of patients of cases with GCS < 8, and mortality were calculated and compared. The incidences of missed diagnosis of various body parts were calculated and compared with one another to identify the multiple injuries prone to be missed during the diagnosis for severe traumatic brain injury patients accompanied by multiple trauma. results: Among the 432 patients, 54 patients had missed injuries. The mean ISS value and the ratio of patients of cases GCS < 8 in the missed group were higher compared with those in the non-missed group. The missed diagnosis ratio of various body parts had significant differences. Injuries in the optic nerve and abdomen were the more often missed injuries in the diagnosis. COnClusIOn:The multiple trauma severity and coma degree impact diagnoses for severe TBI complicated by multiple injuries is highly accurate. The early diagnosis of injury is of the highest importance so that the injury may be treated immediately. KeywOrds: Severe traumatic brain injury, Multiple injury, Missed diagnosis ÖZAmAÇ: Bu çalışmanın amacı 432 hastada atlanması muhtemel çoklu yaralanmaları retrospektif olarak incelemektir. yÖntem ve GereÇler: Vakalar, atlanmış yaralanmanın hastaneye yatma veya takip sırasında bulunmasına göre iki gruba ayrılmıştır. Ortalama ISS değeri, GCS <8 olan hastaların oranı ve mortalite hesaplanmış ve karşılaştırılmıştır. Çeşitli vücut kısımlarında atlanmış tanı insidansları hesaplanmış ve çoklu travma ile birlikte şiddetli travmatik beyin yaralanması olan hastalarda tanı koyma sırasında atlanması muhtemel çoklu yaralanmaları tanımlamak için birbiriyle karşılaştırılmıştır.BulGulAr: 432 hasta içinde 54 hastada atlanmış yaralanmalar bulunmuştur. Atlanmış grupta ortalama ISS değeri ve GCS <8 olan hastaların oranı atlanmamış grupta olanlara göre daha yüksektir. Çeşitli vücut kısımlarında atlamış tanı oranı açısından önemli farklılıklar bulunmuştur. Optik sinir ve karın yaralanmaları tanı koyarken en sık atlanan yaralanmalardır. sOnuÇ: Çoklu yaralanmalarla komplike şiddetli travmatik beyin yaralanması için çoklu travma şiddeti ve koma derecesi etkisi tanıları yüksek ölçüde doğrudur. Yaralanmaya erken tanı konması yaralanmanın hemen tedavi edilebilmesi açısından çok önemlidir.

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