Sex differences in stroke severity, symptoms, and deficits after first-ever ischemic stroke.
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.
Barrett
Kevin M
KM
Department of Neurology, Mayo Clinic, Jacksonville, Florida 32224, USA.
Brott
Thomas G
TG
Brown
Robert D
RD
Frankel
Michael R
MR
Worrall
Bradford B
BB
Silliman
Scott L
SL
Case
L Douglas
LD
Rich
Stephen S
SS
Meschia
James F
JF
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
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