Despite the immeasurable burden on patients and families, no effective therapies to protect the CNS after an acute injury are available yet. Furthermore, the underlying mechanisms that promote neuronal death and functional deficits after injury remain to be poorly understood. The prevalence, age of onset, pathophysiology, and symptomatology of many CNS insults differ significantly between males and females. In the case of stroke, younger males tend to show a higher risk than younger females, while this trend reverses with age. Accumulating evidence from preclinical studies have shown that sex hormones play a crucial role in providing neuroprotection following ischemic stroke and other acute CNS injuries. Estrogen, in particular, exerts a neuroprotective effect by modulating the immune responses after injury. In addition, there exists a sexual dimorphism in cell death pathways between males and females that are independent of hormones. Meanwhile, recent studies suggest that microRNAs are critically involved in the sex-specific mechanisms of cell death. This review discusses the current knowledge on the contribution of sex and age to outcome after stroke. Implication of the interplay between these two factors on other CNS injuries (spinal cord injury and traumatic brain injury) from the experimental evidence were also discussed.

中文翻译：

---

急性中枢神经系统损伤的病理生理中的年龄和性别差异。

尽管给患者和家庭带来了无法估量的负担，但尚无有效的方法来保护急性损伤后的中枢神经系统。此外，促进损伤后神经元死亡和功能缺陷的潜在机制尚不清楚。许多中枢神经系统损伤的患病率，发病年龄，病理生理学和症状学在男性和女性之间都存在显着差异。在中风的情况下，年轻的男性往往比年轻的女性表现出更高的风险，而这种趋势随着年龄的增长而逆转。临床前研究的越来越多证据表明，性激素在缺血性中风和其他急性中枢神经系统损伤后的神经保护中起着至关重要的作用。尤其是雌激素，通过调节损伤后的免疫反应来发挥神经保护作用。此外，雄性和雌性之间的细胞死亡途径中存在一种性状，与激素无关。同时，最近的研究表明，microRNA至关重要地参与了性别特异性的细胞死亡机制。这篇评论讨论了关于性别和年龄对中风后结局的贡献的当前知识。从实验证据还讨论了这两个因素之间的相互作用对其他中枢神经系统损伤（脊髓损伤和脑外伤）的影响。