Sexual and gender aspects of cerebral infarction: a modern view

Cerebral infarction is one of the leading causes of disability and mortality worldwide. Despite significant progress in understanding its pathogenesis and improving therapeutic approaches, increasing attention has been paid to the role of patient sex in the course of the disease. Sex- and gender-related differences may influence epidemiological characteristics, clinical presentation, time to seeking medical care, therapeutic decision-making, features of the acute phase, and outcomes. Investigation of these aspects is an important component in the implementation of personalized approaches to the diagnosis, treatment, and rehabilitation of patients with cerebral infarction. Objective: to analyze contemporary scientific literature in order to identify differences in the clinical course, management, and outcomes of cerebral infarction in women and men. Materials and methods. A review of scientific literature was conducted using the international bibliographic databases PubMed, Scopus, and Web of Science. Relevant publications from 2020 to 2025 were identified using predefined keywords. Bibliosemantic and analytical research methods were applied. Results. The analyzed data indicate the presence of significant differences between women and men in the course of cerebral infarction. Women more frequently experience cerebral infarction at an older age, present with more pronounced clinical manifestations, and have a higher risk of complications. An atypical clinical presentation at disease onset is more common in women, which leads to delayed medical attention. Women are less likely to receive timely thrombolytic therapy. In contrast, men demonstrate a slightly higher mortality rate during the acute phase of the disease, while functional recovery tends to occur more rapidly. These differences are partly explained by hormonal, psychoemotional, social, and behavioral factors. Conclusions. The clinical course of cerebral infarction is determined by the combined influence of biological sex and gender-related factors, which significantly affect clinical manifestations, timeliness of medical care, and recovery outcomes. Consideration of sex- and gender-specific features may contribute to the optimization of medical care and improvement of rehabilitation outcomes. Further studies are required to deepen the understanding of the mechanisms underlying these differences and to adapt them to clinical management strategies.