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    Meeting Highlights: Atypical stroke symptoms more common in women


    Atypical stroke symptoms more common in women

    Classic symptoms are often absent in women who suffer stroke. Whether or not this absence of classic symptoms is responsible for treatment delays in women compared with men needs to be examined, according to Julia Gargano, MS, a doctoral candidate in epidemiology at Michigan State University, East Lansing.

    Women are about half as likely as men to receive tissue-type plasminogen activator (t-PA) as a treatment for stroke, according to data from a Michigan stroke registry, noted Ms Gargano. Compared with men, women with stroke arrive at the emergency department (ED) later, have a longer wait to see an ED physician, and they often wait longer after ED arrival to see a neurologist.

    Chief complaints were analyzed from 1724 patients in the ED who were ultimately confirmed to have a stroke. These complaints were consistent with the American Stroke Association's warning signs—sudden numbness or weakness, sudden confusion, trouble speaking or understanding, sudden trouble seeing, sudden trouble walking, dizziness, or loss of balance, and/or sudden, severe headache.

    "The big difference is that 10% of males and 15% of females had none of the 5 warning signs, at least as they described their chief complaint," said Ms Gargano. After adjusting for other factors, women were 40% less likely to report difficulty with walking, balance or coordination, or dizziness; were 20% less likely to report trouble seeing; and 33% less likely to report any of the 5 warning signs, she said.

    The most common complaints among the patients without any of the warning signs were loss of consciousness or syncope, respiratory complaints, falls or accidents, pain, and seizure. Each of these complaints was more common among women than men. For example, of those with pain as their chief compliant, 70% were women; and among those with falls or accidents as the chief complaint, 63% were women.

    "Our research group is currently trying to understand the role of the presenting symptoms on delays in evaluation observed in our Michigan stroke registry data," Ms Gargano said. These data show that 59% of men but only 44% of women who were ultimately confirmed to have stroke (but who arrive less than 2 hours after symptom onset) received brain imaging within 60 minutes of ED arrival. "This was present in every age-group that we considered, so it's not simply explained by women being older," she added.

    Source: Gargano JW, Wehner S, Reeves MJ. Sex differences in clinical presentation among confirmed acute stroke admissions from a statewide stroke registry. Stroke. 2007;38:508. Abstract P102.

    Atypical stroke symptoms more common in women

    Classic symptoms are often absent in women who suffer stroke. Whether or not this absence of classic symptoms is responsible for treatment delays in women compared with men needs to be examined, according to Julia Gargano, MS, a doctoral candidate in epidemiology at Michigan State University, East Lansing.

    Women are about half as likely as men to receive tissue-type plasminogen activator (t-PA) as a treatment for stroke, according to data from a Michigan stroke registry, noted Ms Gargano. Compared with men, women with stroke arrive at the emergency department (ED) later, have a longer wait to see an ED physician, and they often wait longer after ED arrival to see a neurologist.

    Chief complaints were analyzed from 1724 patients in the ED who were ultimately confirmed to have a stroke. These complaints were consistent with the American Stroke Association's warning signs—sudden numbness or weakness, sudden confusion, trouble speaking or understanding, sudden trouble seeing, sudden trouble walking, dizziness, or loss of balance, and/or sudden, severe headache.

    "The big difference is that 10% of males and 15% of females had none of the 5 warning signs, at least as they described their chief complaint," said Ms Gargano. After adjusting for other factors, women were 40% less likely to report difficulty with walking, balance or coordination, or dizziness; were 20% less likely to report trouble seeing; and 33% less likely to report any of the 5 warning signs, she said.

    The most common complaints among the patients without any of the warning signs were loss of consciousness or syncope, respiratory complaints, falls or accidents, pain, and seizure. Each of these complaints was more common among women than men. For example, of those with pain as their chief compliant, 70% were women; and among those with falls or accidents as the chief complaint, 63% were women.

    "Our research group is currently trying to understand the role of the presenting symptoms on delays in evaluation observed in our Michigan stroke registry data," Ms Gargano said. These data show that 59% of men but only 44% of women who were ultimately confirmed to have stroke (but who arrive less than 2 hours after symptom onset) received brain imaging within 60 minutes of ED arrival. "This was present in every age-group that we considered, so it's not simply explained by women being older," she added.

    Source: Gargano JW, Wehner S, Reeves MJ. Sex differences in clinical presentation among confirmed acute stroke admissions from a statewide stroke registry. Stroke. 2007;38:508. Abstract P102.