Abstract:
Stroke by mechanism of thrombotic cerebral ischemia is one
of the leading causes of death and/or disability worldwide.
Current research is under consensus that there are sex-based
differences in both the prevalence and presentation of stroke
and thrombosis. Here we discuss the interrelation between
thrombosis and inflammation and call attention to points in the
cerebral ischemic cascade where estrogen may be involved in
neuroprotection. Cerebral ischemia triggers a series of events
including inflammation, which is deeply interrelated with
thrombosis; inflammation not only produces local thrombosis,
but thrombosis can also amplify inflammation especially
through the synergism of leukocyte and platelet activity.
Research involving experimental animal models of cerebral
ischemia has shown that sex hormones, especially estrogen,
offer a degree of neuroprotection. Mechanisms of this neuroprotection
may be linked to certain anti-inflammatory properties
of estrogen, as well as estrogen ’ s regulation of thrombosis
through the lowering of coagulation factors, among others. It
is also understood that sex hormones alter the function and
morphology of platelets and fibrin networks, and changes
in platelet and fibrin network morphology offer one of the
earliest confirmations of inflammation. Sex hormone levels,
inflammatory processes, and thrombotic mechanisms are profoundly
interconnected in predicting the outcome of cerebral
ischemia.
