Woman and ictus

Authors: Z. Kalita
Authors‘ workplace: Neurologické oddělení, Krajská nemocnice T. Bati, a. s., Zlín
Published in: Cesk Slov Neurol N 2008; 71/104(2): 148-155
Category: Review Article


Brains strokes are serious and frequent disorders.  According to randomised clinical studies and experimental research, there are differences between the sexes in terms of incidence and nature of ictuses, specifically with respect to age distribution, specific ictus risk factors (pregnancy, oral contraception, postmenopausal hormone replacement therapy and migraine) and different distribution or atherosclerotic stenosing changes in cerebral arteries. Statistically significant benefit of acetylsalicylic acid has been recorded primary prevention in women aged 45 and above and there are also certain differences between the sexes both in terms of acute treatment (intra-arterial thrombolysis) and secondary prevention. Estrogen and the fluctuation of its level during the menstrual cycle, in menopause and postmenopause, play a central role in the above differences. Estrogen modulates the formation of endothelial factors, maintains vasodilatation, and the antiproliferative and antiadhesive properties of the endothelium. Estrogen suppresses inflammation and also influences haemostasis and increases the risk of venous thromboembolia.  It mostly acts via the bond to specific receptors and its action is influenced by gene polymorphism.

Key words:
brain stroke – pregnancy – hormone therapy - acetylsalicylic acid – estrogen – neurovascular unit – gene polymorphism


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