Gender differences in risk for brain lesions

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Neuropsychologists are generally more interested in brain pathology than in pathology of other body tissues. Several gender ratios in cerebral disease seem to depend on sociocultural factors. In his compilation and analysis of 800 medical records of patients with brain diseases in a hospital serving a severely socioeconomically disadvantaged community (with a very high proportion of impoverished single mothers) in the city of Montreal,  Alain St-Marseille found that there are nearly as many women with cerebrovascular accidents as there are men.   He interprets this as an effect of stressful living conditions of the women.   More precisely,  he suggests that in the middle classes,  men are more stressed than women,  but that in the very low social classes,  women are more stressed than men.    However,  there is another factor involved:  his sample consisted of elderly patients only,  and we know that early onset of disease is generally typical of the male sex.  Finally,  I suppose that impoverished post-menopausal women seldom opt for estrogen replacement therapy,   thus depriving themselves of a potent protection against cardiovascular disease.

Student’s tribune:  Men and boys are more at risk for most kinds of brain damage

My students,  Isabelle Montour-Proulx, Caroline Larocque and Loïc Villeneuve, and I, have had the opportunity,  recently,  of completing a vast meta-analytic investigation of 563 cases of radiologically confirmed unilateral cortical brain lesions (lesions of the gray matter mantle of the brain in only one hemisphere).   We tried to draw every single relevant published case into our data bank (we had numerous selection criteria that need not be mentioned exhaustively here). We also went through medical dossiers of several large hospitals and drew all the relevant cases we could find. There were as many children as adults in the overall sample.  Because one of our selection criteria was availability of IQ scores (intelligence quotients),  this represents a rather particular data base for epidemiological analysis.  I feel it is nevertheless interesting to mention here the distribution, as a function of gender,  of the pathoetiologies (the causes of the lesions) of these numerous cases.   We found that males were more at risk for unilateral cortical lesions as a whole (a ratio of 1.8:1).  Onset in males was significantly earlier (26 years,  versus 34 years).  Vascular etiology (or cause) of the lesion was much more frequent (157 males to 60 females,  i.e., 2.6:1),  as was tumoral etiology (50 males to 32 females, i.e., 1.6:1).   Epilepsy was also present more often in the male sex (139 males to 108 females, i.e., 1.3:1).   Of course,  head trauma was a more common etiology in males than in females,  especially in the children (69 males to 17 females,  i.e., 4.1:1).  Finally,  these brain lesions were not caused by infections frequently enough to support comparison of the sexes.