Skip Navigation LinksHome > February 2009 - Volume 41 - Issue 1 > Estrogen and Stroke: A Review of the Current Literature
Journal of Neuroscience Nursing:
doi: 10.1097/JNN.0b013e3181967a7c
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Estrogen and Stroke: A Review of the Current Literature

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Back to Top | Article Outline

CE TEST QUESTION

GENERAL PURPOSE OF THE CE ACTIVITY: To provide the registered professional nurse with an overview of research on the relationship of estrogen to stroke.

LEARNING OBJECTIVES: After reading these article and taking this test, you should be able to:

1. Describe the different types of strokes and estrogens.

2. Discuss the latest research on the relationship between estrogen and stroke.

1. Stroke types include all of the following except

a. subdural hematoma.

b. ischemic stroke.

c. intracerebral hemorrhage (ICH).

d. subarachnoid hemorrhage (SAH).

2. The annual percentage of people in the United States who die from stroke is

a. 10%.

b. 20%.

c. 30%.

d. 40%.

3. Studies of sex differences and the incidence and outcome of stroke report that

a. estrogen causes better outcomes for women from any stroke type.

b. causative factors have not been established.

c. testosterone provides neuroprotective effect in ischemic stroke in men.

d. hormonal factors other than estrogen result in women having better outcomes after stroke.

4. At older ages, ischemic stroke incidence is

a. similar to incidence at younger ages.

b. equal for men and women.

c. higher for men.

d. higher for women.

5. The type of stroke typically caused by a hypertensive episode is

a. ICH.

b. ischemic stroke.

c. SAH.

d. subdural hematoma.

6. The least treatable, most disabling type of stroke is

a. ischemic stroke.

b. ICH.

c. SAH.

d. subdural hematoma.

7. The type of stroke caused mostly by a ruptured intracranial aneurysm is

a. SAH.

b. ischemic stroke.

c. subdural hematoma.

d. ICH.

8. Just after menopause, the type of stroke women suffer from more than men is

a. ischemic stroke.

b. subdural hematoma.

c. ICH.

d. SAH.

9. Secreted by the ovaries and the least prevalent of female hormones is

a. estetrol.

b. estrone.

c. estriol.

d. estradiol.

10. The female hormone produced by the placenta is

a. estriol.

b. estrone.

c. estradiol.

d. methoxyestrone.

11. The estrogen(s) used in oral contraceptives is/are

a. estrone.

b. estriol.

c. conjugated equine estrogens.

d. estradiol.

12. Of the 57 articles included in this review, only

a. 11 described estrogen neuroprotective effects as conclusive.

b. 19 supported estrogens as a factor in reducing stroke risk.

c. 6 depict estrogen as beneficial for cerebral health.

d. 27 were used only for additional information for readers.

13. Falkeborn (1993) found that women taking hormone replacement therapy (HRT) had

a. an increased risk of SAH.

b. a decrease only in ischemic stroke incidence.

c. a higher risk of ischemic strokes.

d. a reduced risk of all types of stroke.

14. Rau et al. (2003) suggest that estrogen protects cerebral neurons by

a. reducing enzymatic activity.

b. increasing apoptosis in neurons.

c. increasing positive enzymatic neural protection.

d. increasing cellular DNA activity.

15. Auriat (2005) found that estrogen given to rats before induced ICH

a. decreased cerebral blood flow.

b. increased hemorrhage volume.

c. may have contributed to improved long term outcomes.

d. increased lesion size within 7 days.

16. Using male rats in studies of SAH, Yan (2006) reported that estrogen

a. increased cerebral vasospasm but decreased ischemia.

b. decreased cerebral vasospasm but increased mortality.

c. had no beneficial effect.

d. decreased cerebral vasospasm and ischemia.

17. Endothelin-1 affects stroke outcomes by

a. promoting vasodilation after SAH.

b. potentiating cerebral vasospasm after SAH.

c. increasing the presence of 17β estradiol.

d. neutralizing the effect of 17β estradiol.

18. Zhao (2005) reported that co-administration of two neuroprotective estrogens in neurodegenerative insults

a. exerted greater neuroprotective efficacy than individual estrogens.

b. was no more effective than one neuroprotective estrogen.

c. resulted in more vasospasm but less hemorrhage.

d. had no effect on male rat subjects.

19. Pederson (1997) reported that estrogen and combined estrogen-progestin HRT among women 45-64 years old

a. increased the risk of hemorrhagic stroke.

b. decreased vasospasms.

c. had no effect on the risk of hemorrhagic stroke.

d. required multiple administrations to produce beneficial effects.

20. The Women's Health Initiative reported that combination hormone therapy resulted in

a. a 50% decreased risk of ischemic stroke.

b. a 40% increased risk of ischemic stroke.

c. the same risk for ischemic stroke as those who took a placebo.

d. the same risk for ischemic stroke as those who took single estrogen therapy.

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© 2009 American Association of Neuroscience Nurses

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