Sex differences in concussion: a review of brain anatomy, function, and biomechanical response to impact.

OBJECTIVE: Provide a potential explanation for sex differences associated with concussions.

RESEARCH DESIGN: Review of current literature from complementary disciplines to synthesize a theory to explains sex differences in individuals with concussion.

METHODS: Systematic review focusing on sex-related differences in individuals with concussion. Articles published in peer-reviewed journals after 2000 were reviewed and discussed among the authors to determine common themes across the different disciplines represented in the literature review.

RESULTS: There are differences in brain structure between sexes. The male corpus callosum has larger fibers and cross-sectional area compared to females. Females tend to utilize both hemispheres of the brain for most tasks, while males are more lateralized. Computation models of concussive impacts indicate that the greater strains occur at the corpus callosum. The corpus callosum is the conduit for interhemispheric connections within the brain; therefore, it stands to reason that increased strain in this area may affect interhemispheric communications resulting in a difference in perceived symptoms between males and females.

CONCLUSIONS: Strain injury of the corpus callosum may affect females to a greater extent since their ability to process information may become more disrupted than males.