Sex Differences in Stroke Severity, Symptoms, and Deficits After First-ever Ischemic Stroke
Open accessAbstract
Objective The purpose of the study was to assess whether there were sex differences in stroke severity, infarct characteristics, symptoms, or the symptoms-deficit relationship at the time of acute stroke presentation.Methods In a prospective study of 505 patients with first-ever ischemic stroke (the Ischemic Stroke Genetics Study), stroke subtype was centrally adjudicated and infarcts were characterized by imaging. Deficits were assessed by National Institutes of Health Stroke Scale (NIHSS) and stroke symptoms were assessed using a structured interview. Kappa statistics were generated to assess agreement between the NIHSS and the structured interview, and a Chi square test was used to assess agreement between the NIHSS and the structured interview by sex.Results In all, 276 patients (55%) were men and 229 (45%) were women. Ages ranged from 19 to 94 years (median, 65 years). The mean (+/-SD) NIHSS score of 3.8 (+/-4.5) for men and 4.3 (+/-5.2) for women was similar (P = .15). No sex difference was observed for the symptoms of numbness, visual deficits, or language. Weakness occurred in a greater proportion of women (69%) than men (59%) (P = .03). Stroke subtype did not differ significantly between sexes (P = .79). Infarct size and location were similar for each sex. The association between symptoms and neurologic deficits did not differ by sex.Conclusions We found no sex difference in stroke severity, stroke subtype, or infarct size and location in patients with incident ischemic stroke. A greater proportion of women presented with weakness; however, similar proportions of men and women presented with other traditional stroke symptoms.
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On average, both the incidence and the prevalence of stroke are higher in men than in women, though there is high variance between age groups and countries.
“In a systematic review by Appelros et. al, it was shown that there was high variance between age groups and countries, but on average, both the incidence and the prevalence of stroke were higher in men than in women [32].”
From Effect of Caffeine Consumption on the Risk for Neurological and Psychiatric Disorders: Sex Differences in Human (2020) · cites this paper as [32]
Mortality from stroke is greater in women than in men.
“On the other hand, mortality from stroke was greater in women (24.7%) than in men (19.7%).”
From Effect of Caffeine Consumption on the Risk for Neurological and Psychiatric Disorders: Sex Differences in Human (2020) · cites this paper as [32]
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- Authors
- Barrett, K. M., Brott, T. G., Brown, R. D., Frankel, M. R., Worrall, B. B., Silliman, S. L., Case, L. D., Rich, S. S., & Meschia, J. F.
- Affiliations
- Mayo Clinic (US)
- Emory University (US)
- University of Virginia (US)
- University of Florida (US)
- Wake Forest University Health Sciences (US)
- Corresponding author
- Meschia, James F.
- ORCID
- Venue
- Journal of Stroke and Cerebrovascular Diseases
- Publisher
- Elsevier BV
- Published
- 2007-01
- Volume
- 16
- Issue
- 1
- Pages
- 34-39
- ISSN
- 1052-3057 (ISSN-L)
- PMC
- PMC1945157
- OpenAlex
- W2120145127
- Cited by
- 76
- References
- 21
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 5 · 2021: 3 · 2020: 3 · 2018: 5 · 2017: 4 · 2016: 8 · 2015: 8 · 2014: 6 · 2013: 2 · 2012: 4
- FWCI
- 3.67
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Stroke and Cerebrovascular Diseases (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke (R01NS42733, R01NS042733)
- Topics
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cerebrovascular and Carotid Artery Diseases
- Keywords
- sex differences, ischemic stroke, stroke severity, stroke symptoms, neurological deficit, NIHSS, stroke subtypes, infarct size, infarct location, weakness, stroke genetics
- MeSH terms
- Adult, Aged, Aged, 80 and over, Alcohol Drinking, Cerebral Infarction, Brain Ischemia, Diabetes Mellitus, Female, Humans, Hyperlipidemias, Hypertension, Hypesthesia, Language Disorders, Male, Middle Aged, Migraine Disorders, Myocardial Infarction, Prospective Studies, Risk Factors, Severity of Illness Index, Sex Factors, Smoking, Vision Disorders, Muscle Weakness
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