Gender and the injured brain.
Anesthesiologists are frequently confronted with patients who are at risk for neurological complications due to perioperative stroke or prior traumatic brain injury. In this review, we address the growing and fascinating body of data that suggests gender and sex steroids influence the pathophysiology of injury and outcome for these patients. Cerebral ischemia, traumatic brain injury, and epilepsy are reviewed in the context of potential sex differences in mechanisms and outcomes of brain injury and the role of estrogen, progesterone, and androgens in shaping these processes. Lastly, implications for current and future perioperative and intensive care are identified.
Vagnerova
Kamila
K
Department of Anesthesiology and Peri-Operative Medicine, Oregon Health and Science University, Portland, Oregon 97239, USA.
Koerner
Ines P
IP
Hurn
Patricia D
PD
D001930:Brain Injuries / Q000188:drug therapy / Q000503:physiopathology*; D002545:Brain Ischemia / Q000188:drug therapy / Q000503:physiopathology*; D002986:Clinical Trials as Topic; D003422:Critical Care; D004827:Epilepsy / Q000188:drug therapy / Q000503:physiopathology*; D004958:Estradiol / Q000502:physiology; D015914:Estrogen Replacement Therapy; D005260:Female; D012739:Gonadal Steroid Hormones / Q000502:physiology* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D018696:Neuroprotective Agents / Q000627:therapeutic use; D011300:Preoperative Care; D011374:Progesterone / Q000502:physiology / Q000627:therapeutic use; D012727:Sex Characteristics; D015398:Signal Transduction; D020521:Stroke / Q000188:drug therapy / Q000503:physiopathology*; D013739:Testosterone / Q000502:physiology
D012739:Gonadal Steroid Hormones; D018696:Neuroprotective Agents; D013739:Testosterone; D011374:Progesterone; D004958:Estradiol