title: Sex differences in stroke severity, symptoms, and deficits after first-ever ischemic stroke.
abstract: 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.
authors: Department of Neurology, Mayo Clinic, Jacksonville, Florida 32224, USA.
authors: Kevin M
authors: KM
authors: Barrett
authors: Thomas G
authors: TG
authors: Brott
authors: Robert D
authors: RD
authors: Brown
authors: Michael R
authors: MR
authors: Frankel
authors: Bradford B
authors: BB
authors: Worrall
authors: Scott L
authors: SL
authors: Silliman
authors: L Douglas
authors: LD
authors: Case
authors: Stephen S
authors: SS
authors: Rich
authors: James F
authors: JF
authors: Meschia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D002545:Brain Ischemia / Q000145:classification / Q000150:complications / Q000453:epidemiology*; D002544:Cerebral Infarction / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D006987:Hypesthesia / Q000209:etiology; D007806:Language Disorders / Q000209:etiology; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology; D018908:Muscle Weakness / Q000209:etiology; D009203:Myocardial Infarction / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D014786:Vision Disorders / Q000209:etiology
references: Md State Med J. 1965 Feb;14:61-5
references: 14258950
references: Stroke. 1999 Nov;30(11):2347-54
references: 10548669
references: Stroke. 2000 May;31(5):1076-80
references: 10797168
references: J Intern Med. 2002 Aug;252(2):121-9
references: 12190887
references: Ann Emerg Med. 2002 Nov;40(5):453-60
references: 12399786
references: Stroke. 2003 Jul;34(7):1581-5
references: 12805490
references: Ital Heart J. 2003 Jun;4(6):371-3
references: 12898800
references: BMC Neurol. 2003 Jul 8;3:4
references: 12848902
references: Lancet. 1975 Mar 1;1(7905):480-4
references: 46957
references: Stroke. 1981 May-Jun;12(3):288-93
references: 7245292
references: Arch Intern Med. 1985 Oct;145(10):1800-3
references: 4037940
references: Stroke. 1989 Jun;20(6):828
references: 2728057
references: Lancet. 1991 Jun 22;337(8756):1521-6
references: 1675378
references: Stroke. 1993 Jan;24(1):35-41
references: 7678184
references: Stroke. 1995 Jan;26(1):46-51
references: 7839396
references: Am J Emerg Med. 1998 Jul;16(4):363-6
references: 9672451
references: Stroke. 1999 Aug;30(8):1538-41
references: 10436097